Respiratory complications in Human Immunodeficiency Virus (HIV) patients remain under-recognized. This study aimed to determine the prevalence of respiratory symptoms and evaluate ventilatory function in HIV-infected patients receiving Antiretroviral Therapy (ART) in Edo State, Nigeria. This is a comparative cross-sectional study which involved 75 HIV-positive subjects and 75 age- and gender-matched control subjects. Data on demographics, health, and lifestyle factors were collected. Anthropometric measurements and lung function tests (spirometry) were performed. The demographic distribution between HIV-positive and control groups showed no significant differences based on gender, age, marital status, and educational level.All HIV-infected subjects were on antiretroviral therapy (ART), with 32% having been diagnosed 1-5 years ago, and 40% having been on ART for 6-10 years. About 41.33% of them were taking additional medications for respiratory symptoms.In terms of lifestyle, alcohol consumption was significantly lower among HIV-positive subjects (14.67% vs. 32.00%; p=0.031). HIV-positive individuals experienced significantly more respiratory symptoms, including shortness of breath, chest tightness, hemoptysis, nasal congestion, wheezing, and recurrent respiratory infections. Furthermore, 30.67% of the HIV-infected cohort had tuberculosis, 25.33% had asthma, and 8.00% had COPD – all being significantly higher than the control group. Anthropometric parameters, including height, weight, and BMI, showed no significant difference between the two groups, irrespective of gender.Lung function assessment revealed significantly reduced Forced Vital Capacity (FVC) and Forced Expiratory Volume in 1 second (FEV1) in HIV-positive subjects, for both genders, compared to the control group. The Peak Expiratory Flow Rate (PEFR) was also notably lower in HIV-positive subjects. Respiratory symptoms and compromised ventilatory functions are prevalent among HIV-infected individuals in Edo State, Nigeria. Early identification and management of respiratory complications in this population are imperative to improve their quality of life

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