PDF(Pubmed)
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.
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.
摘要：
背景：感染艾滋病毒（WLHIV）的女性SARS-CoV-2血清阳性数据，他们的婴儿和该亚群中的相关因素仍然有限.我们在乌干达的PROMOTE观察队列中回顾性地测量了WLHIV及其子女从07/2020-11/2021的SARS-CoV-2血清阳性，马拉维,和津巴布韦在这些国家广泛接种SARS-CoV-2疫苗之前。
方法：使用血清学检测对SARS-CoV-2刺突蛋白的适应性免疫反应，对东非/南部非洲COVID-19大流行的3波中储存的血浆进行了SARS-CoV-2特异性IgG抗体（Ab）的检测。（EUROIMMUN，山湖,新泽西和罗氏诊断,印第安纳波利斯,IN).使用改进的泊松回归模型计算患病率比（PRR）和95％置信区间（CI），以确定社会人口统计学和临床危险因素。
结果：分析了918名母亲和1237名儿童的PROMOTE样本。总的来说,孕产妇SARS-CoV-2血清阳性为60.1%(95%CI:56.9-63.3),儿童为41.5%(95CI:38.8-44.2).与母乳喂养的母亲相比，非母乳喂养的母亲发生SARS-CoV-2血清阳性的风险高31％（aPRR=1.31，95CI：1.08-1.59）。病毒载量检测不到的WLHIV的SARS-CoV-2血清阳性风险增加10％（aPRR=1.10，95CI：0.89-1.37）。此外，与高血压女性相比,血压正常的患者SARS-CoV-2血清阳性风险增加12%(aPRR=1.12,95%CI:0.68~1.85).与年幼的儿童相比，2至5岁的儿童患SARS-CoV-2血清阳性的风险降低了19％（aPRR=0.81，95CI：0.64-1.02）。在接受测试的346/802（43.1％）家庭中，母亲/婴儿SARS-CoV-2血清状态不一致：母亲/儿童占72.3％；母亲-/儿童占26.3％；儿童/兄弟姐妹的一致性为34.6％。
结论：这些SARS-CoV-2血清阳性数据表明，到2021年底，在东部/南部非洲受艾滋病毒影响的家庭队列中，约60％的母亲和约40％的儿童感染了SARS-CoV-2。更多的母亲比他们的婴儿测试SARS-CoV-2+，可能是由于母亲与日常生活/就业相关的外部暴露更大，学校关闭。母乳喂养对母亲有保护作用,可能是因为和年幼的孩子呆在家里的可能性更高，从而减少曝光。同一家庭内儿童之间的不一致结果强调需要进一步了解家庭内的传播动态。
方法：使用血清学检测对SARS-CoV-2刺突蛋白的适应性免疫反应，对东非/南部非洲COVID-19大流行的3波中储存的血浆进行了SARS-CoV-2特异性IgG抗体（Ab）的检测。（EUROIMMUN，山湖,新泽西和罗氏诊断,印第安纳波利斯,IN).使用改进的泊松回归模型计算患病率比（PRR）和95％置信区间（CI），以确定社会人口统计学和临床危险因素。
结果：分析了918名母亲和1237名儿童的PROMOTE样本。总的来说,孕产妇SARS-CoV-2血清阳性为60.1%(95%CI:56.9-63.3),儿童为41.5%(95CI:38.8-44.2).与母乳喂养的母亲相比，非母乳喂养的母亲发生SARS-CoV-2血清阳性的风险高31％（aPRR=1.31，95CI：1.08-1.59）。病毒载量检测不到的WLHIV的SARS-CoV-2血清阳性风险增加10％（aPRR=1.10，95CI：0.89-1.37）。此外，与高血压女性相比,血压正常的患者SARS-CoV-2血清阳性风险增加12%(aPRR=1.12,95%CI:0.68~1.85).与年幼的儿童相比，2至5岁的儿童患SARS-CoV-2血清阳性的风险降低了19％（aPRR=0.81，95CI：0.64-1.02）。在接受测试的346/802（43.1％）家庭中，母亲/婴儿SARS-CoV-2血清状态不一致：母亲/儿童占72.3％；母亲-/儿童占26.3％；儿童/兄弟姐妹的一致性为34.6％。
结论：这些SARS-CoV-2血清阳性数据表明，到2021年底，在东部/南部非洲受艾滋病毒影响的家庭队列中，约60％的母亲和约40％的儿童感染了SARS-CoV-2。更多的母亲比他们的婴儿测试SARS-CoV-2+，可能是由于母亲与日常生活/就业相关的外部暴露更大，学校关闭。母乳喂养对母亲有保护作用,可能是因为和年幼的孩子呆在家里的可能性更高，从而减少曝光。同一家庭内儿童之间的不一致结果强调需要进一步了解家庭内的传播动态。
