TY - JOUR
T1 - HIV and SARS-CoV-2 infection in postpartum Kenyan women and their infants
AU - Begnel, Emily R.
AU - Chohan, Bhavna H.
AU - Ojee, Ednah
AU - Adhiambo, Judith
AU - Owiti, Prestone
AU - Ogweno, Vincent
AU - Holland, La Rinda A.
AU - Fish, Carolyn S.
AU - Richardson, Barbra A.
AU - Khan, Adam K.
AU - Maqsood, Rabia
AU - Lim, Efrem S.
AU - Sadarangani, Manish
AU - Lehman, Dara A.
AU - Slyker, Jennifer
AU - Kinuthia, John
AU - Wamalwa, Dalton
AU - Gantt, Soren
N1 - Publisher Copyright:
© 2023 Public Library of Science. All rights reserved.
PY - 2023/1
Y1 - 2023/1
N2 - Background HIV may increase SARS-CoV-2 infection risk and COVID-19 severity generally, but data are limited about its impact on postpartum women and their infants. As such, we characterized SARS-CoV-2 infection among mother-infant pairs in Nairobi, Kenya. Methods We conducted a nested study of 62 HIV-uninfected and 64 healthy women living with HIV, as well as their HIV-exposed uninfected (N = 61) and HIV-unexposed (N = 64) infants, participating in a prospective cohort. SARS-CoV-2 serology was performed on plasma collected between May 1, 2020-February 1, 2022 to determine the incidence, risk factors, and symptoms of infection. SARS-CoV-2 RNA PCR and sequencing was also performed on available stool samples from seropositive participants. Results SARS-CoV-2 seropositivity was found in 66% of the 126 mothers and in 44% of the 125 infants. There was no significant association between SARS-CoV-2 infection and maternal HIV (Hazard Ratio [HR] = 0.810, 95% CI: 0.517–1.27) or infant HIV exposure (HR = 1.47, 95% CI: 0.859–2.53). Maternal SARS-CoV-2 was associated with a two-fold increased risk of infant infection (HR = 2.31, 95% CI: 1.08–4.94). Few participants (13% mothers, 33% infants) had symptoms; no participant experienced severe COVID-19 or death. Seroreversion occurred in about half of mothers and infants. SARS-CoV-2 sequences obtained from stool were related to contemporaneously circulating variants. Conclusions These data indicate that postpartum Kenyan women and their infants were at high risk for SARS-CoV-2 infection and that antibody responses waned over an average of 8–10 months. However, most cases were asymptomatic and healthy women living with HIV did not have a substantially increased risk of infection or severe COVID-19.
AB - Background HIV may increase SARS-CoV-2 infection risk and COVID-19 severity generally, but data are limited about its impact on postpartum women and their infants. As such, we characterized SARS-CoV-2 infection among mother-infant pairs in Nairobi, Kenya. Methods We conducted a nested study of 62 HIV-uninfected and 64 healthy women living with HIV, as well as their HIV-exposed uninfected (N = 61) and HIV-unexposed (N = 64) infants, participating in a prospective cohort. SARS-CoV-2 serology was performed on plasma collected between May 1, 2020-February 1, 2022 to determine the incidence, risk factors, and symptoms of infection. SARS-CoV-2 RNA PCR and sequencing was also performed on available stool samples from seropositive participants. Results SARS-CoV-2 seropositivity was found in 66% of the 126 mothers and in 44% of the 125 infants. There was no significant association between SARS-CoV-2 infection and maternal HIV (Hazard Ratio [HR] = 0.810, 95% CI: 0.517–1.27) or infant HIV exposure (HR = 1.47, 95% CI: 0.859–2.53). Maternal SARS-CoV-2 was associated with a two-fold increased risk of infant infection (HR = 2.31, 95% CI: 1.08–4.94). Few participants (13% mothers, 33% infants) had symptoms; no participant experienced severe COVID-19 or death. Seroreversion occurred in about half of mothers and infants. SARS-CoV-2 sequences obtained from stool were related to contemporaneously circulating variants. Conclusions These data indicate that postpartum Kenyan women and their infants were at high risk for SARS-CoV-2 infection and that antibody responses waned over an average of 8–10 months. However, most cases were asymptomatic and healthy women living with HIV did not have a substantially increased risk of infection or severe COVID-19.
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U2 - 10.1371/journal.pone.0278675
DO - 10.1371/journal.pone.0278675
M3 - Article
C2 - 36649247
AN - SCOPUS:85146484616
SN - 1932-6203
VL - 18
JO - PloS one
JF - PloS one
IS - 1 January
M1 - e0278675
ER -