SARS-CoV-2 cross-sectional serosurvey across three HIV-1 therapeutic clinical trials in Africa
Document Type
Article
Publication Date
3-1-2025
Abstract
Objective:Data on the impact of coronavirus disease 2019 (COVID-19) in people with HIV (PWH) are lacking in resource-constrained settings. We utilized existing randomized clinical trials (RCTs) on antiretroviral therapies (ART) in HIV-1 infection to conduct a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serosurvey, between January and March 2021, while characterizing participants' features. Design:Cross-sectional serosurvey. Methods:Demographic characteristics, medical history and a serum sample were collected from consenting PWH. Samples were analyzed centrally for immunoglobulin G antibodies to recombinant nucleocapsid and spike proteins derived from SARS-CoV-2 using a Luminex based assay. Results:The 549 participants recruited in 9 sites across Africa had a median age of 40 years (interquartile range, IQR 34-45]); 63.0% (346) were female. All were on ART; 81.8% (449) had an HIV-1 viral load <50 copies/ml, with CD4+ cell count median at 478/mm3 (IQR 320-677]). None had received vaccination against SARS-CoV-2. Forty participants (7.3%) had a prior SARS-CoV-2 PCR testing, of whom 10 were positive (1.8%). Crude SARS-CoV-2 seroprevalence was 36.2% (95% confidence interval (CI) 32.2-40.4]). In the explorative multivariable analysis, comparison of the characteristics of PWH with a positive SARS-CoV-2 serology with those with a negative or indeterminate serology: PWH with a body mass index (BMI) >= 30 kg/m2 were more likely to have a positive serology than those with a BMI <25 (adjusted odds ratio (aOR) = 2.39 1.48-3.86], P < 0.001); and PWH living in Cameroon were less likely to have a positive serology. Conclusion:This study demonstrates a substantial seroprevalence level of SARS-CoV-2 in PWH in the first quarter of 2021, with a marked disparity with the number of COVID-19 PCR tests reported positive.
Keywords
Coronavirus disease 2019, People with HIV, Randomized clinical trials, Serology
Divisions
medicinedept
Publication Title
AIDS
Volume
39
Issue
4
Publisher
Wolters Kluwer Health
Publisher Location
TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA