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Abstract：
BACKGROUND: Human immunodeficiency virus (HIV) infection is an important risk factor for Coronavirus Disease 2019 (COVID-19), but data on the prevalence of COVID-19 among people living with HIV (PLWH) is limited in low-income countries. Our aim was to assess the seroprevalence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) specific antibodies and associated factors among PLWH in Sierra Leone.
METHODS: We conducted a cross-sectional survey of PLWH aged 18 years or older in Sierra Leone between August 2022 and January 2023. Participants were tested for SARS-CoV-2 antibodies using a rapid SARS-CoV-2 antibody (immunoglobulin M/immunoglobulin G [IgG]) kits. Stepwise logistic regression was used to explore factors associated with SARS-CoV-2 antibody seroprevalence with a significance level of p < .05.
RESULTS: In our study, 33.4% (1031/3085) participants had received a COVID-19 vaccine, and 75.7% were SARS-CoV-2 IgG positive. Higher IgG seroprevalence was observed in females (77.2% vs. 71.4%, p = .001), adults over 60 years (88.2%), those with suppressed HIV RNA (80.7% vs. 51.7%, p < .001), antiretroviral therapy (ART)-experienced individuals (77.9% vs. 44.6%, p < .001), and vaccinated participants (80.7% vs. 73.2%, p < .001). Patients 60 years or older had the highest odds of IgG seroprevalence (adjusted odds ratio [aOR] = 2.73, 95% CI = 1.68-4.65). Female sex (aOR = 1.28, 95%CI = 1.05-1.56), COVID-19 vaccination (aOR = 1.54, 95% CI = 1.27-1.86), and ART (aOR = 2.20, 95% CI = 1.56-3.11) increased the odds, whereas HIV RNA ≥ 1000 copies/mL (aOR = 0.32, 95% CI = 0.26-0.40) reduced the odds of IgG seroprevalence.
CONCLUSIONS: We observed a high seroprevalence of SARS-CoV-2 antibody among PLWH in Sierra Leone. We recommend the introduction of targeted vaccination for PLWH with a high risk of severe COVID-19, especially those with an unsuppressed HIV viral load.
METHODS: We conducted a cross-sectional survey of PLWH aged 18 years or older in Sierra Leone between August 2022 and January 2023. Participants were tested for SARS-CoV-2 antibodies using a rapid SARS-CoV-2 antibody (immunoglobulin M/immunoglobulin G [IgG]) kits. Stepwise logistic regression was used to explore factors associated with SARS-CoV-2 antibody seroprevalence with a significance level of p < .05.
RESULTS: In our study, 33.4% (1031/3085) participants had received a COVID-19 vaccine, and 75.7% were SARS-CoV-2 IgG positive. Higher IgG seroprevalence was observed in females (77.2% vs. 71.4%, p = .001), adults over 60 years (88.2%), those with suppressed HIV RNA (80.7% vs. 51.7%, p < .001), antiretroviral therapy (ART)-experienced individuals (77.9% vs. 44.6%, p < .001), and vaccinated participants (80.7% vs. 73.2%, p < .001). Patients 60 years or older had the highest odds of IgG seroprevalence (adjusted odds ratio [aOR] = 2.73, 95% CI = 1.68-4.65). Female sex (aOR = 1.28, 95%CI = 1.05-1.56), COVID-19 vaccination (aOR = 1.54, 95% CI = 1.27-1.86), and ART (aOR = 2.20, 95% CI = 1.56-3.11) increased the odds, whereas HIV RNA ≥ 1000 copies/mL (aOR = 0.32, 95% CI = 0.26-0.40) reduced the odds of IgG seroprevalence.
CONCLUSIONS: We observed a high seroprevalence of SARS-CoV-2 antibody among PLWH in Sierra Leone. We recommend the introduction of targeted vaccination for PLWH with a high risk of severe COVID-19, especially those with an unsuppressed HIV viral load.
摘要：
背景：人类免疫缺陷病毒（HIV）感染是2019年冠状病毒病（COVID-19）的重要危险因素，但低收入国家的艾滋病病毒感染者（PLWH）中COVID-19患病率的数据有限。我们的目的是评估塞拉利昂PLWH中严重急性呼吸综合征冠状病毒2（SARS-CoV-2）特异性抗体和相关因子的血清阳性率。
方法：我们在2022年8月至2023年1月期间对塞拉利昂18岁或以上的PLWH进行了横断面调查。使用快速SARS-CoV-2抗体（免疫球蛋白M/免疫球蛋白G[IgG]）试剂盒对参与者进行了SARS-CoV-2抗体测试。采用逐步logistic回归分析SARS-CoV-2抗体血清阳性率相关因素，显著性水平p<0.05。
结果：在我们的研究中，33.4%(1031/3085)的参与者接受了COVID-19疫苗，75.7%为SARS-CoV-2IgG阳性。在女性中观察到更高的IgG血清阳性率(77.2%vs.71.4%,p=.001)，60岁以上的成年人（88.2%），那些抑制HIVRNA的人(80.7%vs.51.7%,p<.001),抗逆转录病毒治疗(ART)-有经验的个体(77.9%vs.44.6%,p<.001),和接种疫苗的参与者(80.7%vs.73.2%,p<.001)。60岁或以上的患者IgG血清阳性率最高（调整后的比值比[aOR]=2.73，95％CI=1.68-4.65）。女性（aOR=1.28，95CI=1.05-1.56），COVID-19疫苗接种（aOR=1.54，95%CI=1.27-1.86），ART(aOR=2.20，95%CI=1.56-3.11)增加了几率，而HIVRNA≥1000拷贝/mL(aOR=0.32,95%CI=0.26-0.40)降低了IgG血清阳性率的几率.
结论：我们在塞拉利昂的PLWH中观察到SARS-CoV-2抗体的高血清阳性率。我们建议对严重COVID-19风险较高的PLWH进行靶向疫苗接种，特别是那些HIV病毒载量未抑制的人群。
方法：我们在2022年8月至2023年1月期间对塞拉利昂18岁或以上的PLWH进行了横断面调查。使用快速SARS-CoV-2抗体（免疫球蛋白M/免疫球蛋白G[IgG]）试剂盒对参与者进行了SARS-CoV-2抗体测试。采用逐步logistic回归分析SARS-CoV-2抗体血清阳性率相关因素，显著性水平p<0.05。
结果：在我们的研究中，33.4%(1031/3085)的参与者接受了COVID-19疫苗，75.7%为SARS-CoV-2IgG阳性。在女性中观察到更高的IgG血清阳性率(77.2%vs.71.4%,p=.001)，60岁以上的成年人（88.2%），那些抑制HIVRNA的人(80.7%vs.51.7%,p<.001),抗逆转录病毒治疗(ART)-有经验的个体(77.9%vs.44.6%,p<.001),和接种疫苗的参与者(80.7%vs.73.2%,p<.001)。60岁或以上的患者IgG血清阳性率最高（调整后的比值比[aOR]=2.73，95％CI=1.68-4.65）。女性（aOR=1.28，95CI=1.05-1.56），COVID-19疫苗接种（aOR=1.54，95%CI=1.27-1.86），ART(aOR=2.20，95%CI=1.56-3.11)增加了几率，而HIVRNA≥1000拷贝/mL(aOR=0.32,95%CI=0.26-0.40)降低了IgG血清阳性率的几率.
结论：我们在塞拉利昂的PLWH中观察到SARS-CoV-2抗体的高血清阳性率。我们建议对严重COVID-19风险较高的PLWH进行靶向疫苗接种，特别是那些HIV病毒载量未抑制的人群。
