SARS‐CoV‐2 seroprevalence and associated factors among people living with HIV in Sierra Leone

Abstract

AbstractBackgroundHuman 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.MethodsWe 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.ResultsIn 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.ConclusionsWe 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.