Similar Antibody Responses Against Severe Acute Respiratory Syndrome Coronavirus 2 in Individuals Living Without and With Human Immunodeficiency Virus on Antiretroviral Therapy During the First South African Infection Wave

Clin Infect Dis

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has significantly impacted global health although the true impact of COVID-19 in Africa, the continent that has the most people living with HIV (PLWH), is still unclear. Almost 70% of PLWH lives in sub-Saharan Africa of which only 52% has suppressed HIV infection while the rest are immunocompromised leaving them more vulnerable to infections. This is because HIV affects the immune system and PLWH have poor antibody responses to vaccination and exposure to other natural infections. Recent studies reported that PLWH that also have COVID-19 are more at risk of severed disease and/or death. In our study, we followed 72 participants that had COVID-19, of which 30 of the 72 (41.7%) had HIV, 25 of the 30 (83.0%) participants were on antiretroviral therapy (ART) and therefore had no active HIV in the blood. We collected blood samples every week for 3 months. In total, we measured 294 blood samples against anti–SARS-CoV-2 IgM, IgG and IgA antibodies. We also measured neutralizing antibodies at the beginning of COVID-19 infection and after 3 months of infection for each participant. We found that PLWH that were on Antiretroviral therapy (ART) had similar antibody and neutralizing antibody responses to people not living with HIV. Unfortunately, we did not have enough participants that had active HIV (not on ART) and can therefore not report whether there are differences in antibody responses in this group compared to people not living with HIV. Future work should focus on including more PLWH that are not suppressed. To conclude, this study highlights the importance of a secure supply of ART for PLWH during the first wave of COVID-19 in Africa and provides hope that COVID-19 vaccines will be effective in PLWH on stable ART.

SANTHE is an Africa Health Research Institute (AHRI) flagship programme funded by the Science for Africa Foundation through the DELTAS Africa programme; the Bill & Melinda Gates Foundation; Gilead Sciences Inc.; and the Ragon Institute of Mass General, MIT, and Harvard.