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SARS-COV-2 CROSS-SECTIONAL SEROSURVEY ACROSS THREE HIV-1 THERAPEUTIC CLINICAL TRIALS IN AFRICA
https://www.arca.fiocruz.br/handle/icict/69101
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Abstract
Objective: Data on the impact of COVID-19 in people living with HIV (PWH) are lacking in resource-constrained settings. We utilised existingrandomised clinical trials (RCTs) on antiretroviral therapies (ART) in HIV-1 infection to conduct a SARS-CoV-2 serosurvey, between January and March 2021, while characterising participants' features. Design: Cross-sectional serosurvey. Methods: Demographic characteristics, medical history and a serum sample were collected from consenting PWH. Samples were analysed centrally for immunoglobulin G antibodies to recombinant nucleocapsid and spike proteins derived from SARS-CoV-2 using a Luminex based assay. Results: The 549participants recruited in 9 sites across Africa had a median age of 40 years (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 count median at 478/mm 3 (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%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/m 2 were more likely to have a positive serology than those with a BMI≤25 (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.
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