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.
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。