HIV and SARS-CoV-2 infection in postpartum Kenyan women and their infants

Emily R. Begnel, Bhavna H. Chohan, Ednah Ojee, Judith Adhiambo, Prestone Owiti, Vincent Ogweno, La Rinda A. Holland, Carolyn S. Fish, Barbra A. Richardson, Adam K. Khan, Rabia Maqsood, Efrem S. Lim, Manish Sadarangani, Dara A. Lehman, Jennifer Slyker, John Kinuthia, Dalton Wamalwa, Soren Gantt

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Article numbere0278675
JournalPloS one
Volume18
Issue number1 January
DOIs
StatePublished - Jan 2023
Externally publishedYes

ASJC Scopus subject areas

  • General

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