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. 2024 Aug 8:12:100421.
doi: 10.1016/j.ijregi.2024.100421. eCollection 2024 Sep.

SARS-CoV-2 seroprevalence in people living with HIV in South Sudan

Helen M Chun  1 , Dennis K Lodiongo  2 , Kyle Milligan  1   3 , Grace J Lesuk  4 , Divya Patel  1 , Ray W Shiraishi  1 , Diana Martin  5 , Ashley K Simon  5 , Emilio Dirlikov  6 , Hetal K Patel  1 , Dennis Ellenberger  1 , Habtamu A Worku  4 , Yen T Duong  7 , Robert O Ekong  4 , Joel S Katoro  2 , Shambel A Hussen  4 , Michael L Lokore  8 , Gregory Wani  8 , Sudhir Bunga  2
Affiliations

SARS-CoV-2 seroprevalence in people living with HIV in South Sudan

Helen M Chun et al. IJID Reg. .

Abstract

Objectives: The burden of SARS-CoV-2 infection in people living with HIV (PLHIV) in South Sudan is unknown.

Methods: We conducted a cross-sectional seroprevalence survey of SARS-CoV-2 immunoglobulin (Ig) G antibodies and other diseases of public health importance (strongyloidiasis, toxoplasmosis) in PLHIV in South Sudan during April 1, 2020-April 30, 2022. We used a multiplex SARS-CoV-2 immunoassay to detect IgG antibodies targeting the SARS-CoV-2 spike, receptor binding domain, and nucelocapsid (N) proteins, and antigens for other pathogens (Strongyloides stercoralis and Toxoplasma gondii).

Results: Among 3518 samples tested, seroprevalence of IgG antibodies to SARS-CoV-2 spike protein and receptor binding domain 591 and nucleocapsid ranged from 1.4% (95% confidence interval [CI]: 0.9-2.1%) in April-June 2020 to 53.3% (95% CI: 49.5-57.1%) in January-March 2022. The prevalence of S. stercoralis IgG ranged between 27.3% (95% CI: 23.4-31.5%) in October-December 2021 and 47.2% (95% CI: 37.8-56.8%) in July-September 2021, and, for T. gondii IgG, prevalence ranged from 15.5% (95% CI: 13.3-17.9%) in April-June 2020 to 36.2% (95% CI: 27.4-46.2%) July-September 2021.

Conclusions: By early 2022, PLHIV in South Sudan had high rates of SARS-CoV-2 seropositivity. Surveillance of diseases of global health concern in PLHIV is crucial to estimate population-level exposure and inform public health responses.

Keywords: COVID-19; People living with HIV; SARS-CoV-2; Seroprevalence.

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Conflict of interest statement

The authors have no competing interests to declare.

Figures

Figure 1
Figure 1
SARS-CoV-2 seroprevalence. Proportion (95% confidence interval) of samples tested each round that were S+N+, S+N−, and S+ overall. Confidence intervals were calculated accounting for the survey design (weighting and stratification). MFI, median fluorescence intensity; N, nucleocapsid; RBD, receptor binding domain; S, spike.aS+N+: S protein antibody MFI value ≥328 AND RBD antibody MFI value ≥281 AND N protein antibody MFI value ≥389; bS+N−: S protein antibody MFI value ≥328 AND RBD antibody MFI value ≥281 AND N protein antibody MFI value < 389; cS+: S protein antibody MFI value ≥328 AND RBD antibody MFI value ≥281, irrespective of N protein antibody MFI value; dNo samples were collected in October-December 2020 or April-June 2021.
Figure 2
Figure 2
Estimated mean median fluorescence intensity values for antibodies to SARS-CoV-2 in people living with HIV on antiretroviral therapy in South Sudan by round, pooled across states (log-scale), April 2020-April 2022. Mean (95% confidence interval) median fluorescence intensity values for antibodies to SARS-CoV-2 in people living with HIV on antiretroviral therapy in South Sudan by round, pooled across states (log-scale), April 2020-April 2022. Confidence intervals were calculated accounting for the survey design (weighting and stratification). aS: spike; bRBD: receptor binding domain; cN: nucleocapsid; dNo samples were collected in October-December 2020 or April-June 2021.
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