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. 2024 Jul 11;24(1):693.
doi: 10.1186/s12879-024-09591-8.

SARS-CoV-2 seropositivity in African women living with HIV and their infants

Taguma A Matubu  1 , Nonhlanhla Yende-Zuma  2   3 , Sean S Brummel  4 , Lynda Stranix-Chibanda  5   6 , Lillian Wambuzi Ogwang  7 , Sufia Dadabhai  8 , Patience Atuhaire  7 , Felluna Chauwa  9 , Luis Gadama  9 , Reinaldo E Fernandez  10 , Jim Aizire  8 , JBrooks Jackson  11 , Aaron A R Tobian  10 , Taha E Taha  8 , Mary Glenn Fowler  10
Affiliations

SARS-CoV-2 seropositivity in African women living with HIV and their infants

Taguma A Matubu et al. BMC Infect Dis. .

Abstract

Background: SARS-CoV-2 seropositivity data in women living with HIV (WLHIV), their infants and associated factors in this subpopulation remain limited. We retrospectively measured SARS-CoV-2 seropositivity from 07/2020-11/2021 among WLHIV and their children in the PROMOTE observational cohort in Uganda, Malawi, and Zimbabwe prior to widespread SARS-CoV-2 vaccination in those countries.

Methods: Plasma stored during 3 waves of the COVID-19 pandemic in East/Southern Africa were tested for SARS-CoV-2 specific IgG antibodies (Ab) using serological assays that detect adaptive immune responses to SARS-CoV-2 spike protein. (EUROIMMUN, Mountain Lakes, New Jersey and Roche Diagnostics, Indianapolis, IN). Modified-Poisson regression models were used to calculate prevalence rate ratios (PRR) and 95% confidence intervals (CI) to identify sociodemographic and clinical risk factors.

Results: PROMOTE samples from 918 mothers and 1237 children were analysed. Overall, maternal SARS-CoV-2 seropositivity was 60.1% (95% CI: 56.9 -63.3) and 41.5% (95%CI: 38.8 - 44.2) for children. Non-breastfeeding mothers had a 31% higher risk of SARS-CoV-2 seropositivity compared to breastfeeding mothers (aPRR=1.31, 95%CI: 1.08-1.59). WLHIV with undetectable viral load had a 10% increased risk of SARS-CoV-2 seropositivity (aPRR=1.10, 95%CI: 0.89-1.37). Moreover, those who were normotensive had 12% increased risk SARS-CoV-2 seropositivity (aPRR= 1.12, 95% CI: 0.68-1.85) compared to women with hypertension. Children between 2 and 5 years had a 19% reduced risk of SARS-CoV-2 seropositivity (aPRR=0.81, 95%CI: 0.64-1.02) when compared to younger children. Mother/infant SARS-CoV-2 serostatuses were discordant in 346/802 (43.1%) families tested: mothers+/children- in 72.3%; mothers-/children+ in 26.3%; child+/sibling+ concordance was 34.6%.

Conclusions: These SARS-CoV-2 seropositivity data indicate that by late 2021, about 60% of mothers and about 40% of children in a cohort of HIV-affected families in eastern/southern Africa had been infected with SARS-CoV-2. More mothers than their infants tested SARS-CoV-2+, likely due to a greater external exposure for mothers linked to daily routines/employment, and school closures. Breastfeeding was protective for mothers, likely because of higher likelihood of staying home with young children, and thus less exposure. Discordant results between children within the same families underscores the need to further understand transmission dynamics within households.

Keywords: Children; SARS-CoV-2; Seropositivity; WLHIV.

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Conflict of interest statement

I declare that the authors have no competing interests or any other such interests that might be deemed to have an influence on the results and/or discussion presented in this manuscript.

Figures

Fig. 1
Fig. 1
Flowchart for participants in seropositivity of SARS-CoV-2 antibodies study in three African countries between July 2020 and November 2021
Fig. 2
Fig. 2
SARS-CoV-2 antibody seropositivity estimates over time for Malawi, Uganda, and Zimbabwe. A Shows SARS-CoV-2 antibody seropositivity rates over time for mothers and their children relative to COVID-19 trends over time in Malawi. Arrow depicts the period during which national COVID-19 vaccine program was launched. Rectangular boundary represents the study sampling period. B Shows SARS-CoV-2 antibody positivity rates over time for mothers and their Children relative to COVID-19 trends over time in Uganda. Arrow depicts the period during which national COVID-19 vaccine program was launched. Rectangular boundary represents the study sampling period. C Shows SARS-CoV-2 antibody positivity rates over time for mothers and their Children relative to COVID-19 trends over time in Zimbabwe. Arrow depicts the period during which national COVID-19 vaccine program was launched. Rectangular boundary represents the study sampling period
See this image and copyright information in PMC

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