Title

Prevalence of SARS-CoV-2 among persons on HIV antiretroviral treatment in Mozambique: baseline characteristics among participants of the COVIV cohort study

Presenter

Caroline De Schacht

Authors

C. De Schacht¹, E. Nhacule², C. Belo¹, P. Young³, I. Meque⁴, F. Júnior⁵, T. Madede⁶, R. Cumbane⁶, A.Q. Muteerwa³, D.A. Bila⁷, S. Pereira², N. Cavele², J.L. Manuel⁸, O.M. Ali⁹, U. Chibale⁸, G. Amorim¹⁰, E. Viegas²

Institutions

¹Friends in Global Health, Maputo, Mozambique, ²Instituto Nacional de Saúde, Maputo, Mozambique, ³Division of Global HIV & TB, U.S. Centers for Disease Control and Prevention (CDC), Maputo, Mozambique, ⁴Elizabeth Glaser Pediatric AIDS Foundation, Maputo, Mozambique, ⁵Elizabeth Glaser Pediatric AIDS Foundation, Inhambane, Mozambique, ⁶Centro de Colaboração em Saúde, Maputo, Mozambique, ⁷Fundação Ariel Contra o SIDA Pediátrico (ARIEL), Maputo, Mozambique, ⁸Instituto Nacional de Saúde, Beira, Mozambique, ⁹Abt Associates (ECHO Project), Maputo, Mozambique, ¹⁰Vanderbilt University Medical Center (VUMC), Department of Biostatistics, Nashville, United States

BACKGROUND: The impact of the COVID-19 epidemic among persons living with HIV (PLHIV) is unknown in Mozambique. The COVIV (“COVID/HIV”) cohort study, implemented in three provinces, aims to investigate prevalence and incidence of SARS-CoV-2 among PLHIV in care. The present analysis describes the baseline characteristics of enrolled participants.
METHODS: Participants were recruited at three health facilities in Maputo, Inhambane and Zambézia provinces. All were screened at baseline for COVID-19 risk, using a standardized risk assessment questionnaire, and for SARS-CoV-2 antibodies, using Abbott™ IgM/IgG antibody rapid test (AB-RT). Those with either positive risk assessment or AB-RT underwent SARS-CoV-2 PCR testing. Participants, selected at convenience, were enrolled in one of the following arms, depending on the presence of active infection/exposure, irrespectively of COVID-19 vaccination status: 1) not-actively-infected/not-exposed (AB-RT and PCR negative); 2) active COVID-19 infection (PCR positive); 3) not-actively-infected/exposed (AB-RT positive and PCR negative).
RESULTS: A total of 1286 PLHIV were recruited from June 2021 to April 2022 (which included the 3^rd [June-September2021] and 4^th wave [December2021-January2022] of the country’s epidemic); 637 (49.5%) in Maputo, 296 (23.0%) in Inhambane, 353 (27.4%) in Zambézia. Median age was 40 years (IQR [interquartile range]:32-49), 65.3% (840/1286) were female. Median time on ART was 5.3 years (IQR:2.7-8.7), median CD4+ T-cell count was 506 cells/mm³ (IQR:367-671), and 1016/1076 (94.4%) who had a viral load result within 12 months prior to enrollment were virally suppressed. Among enrolled participants, 410 (32%) tested positive for SARS-CoV-2 IgG/IgM, and 777 (60.4%) underwent PCR testing based on risk assessment/AB-RT. Among those with PCR testing, 64 (8.2%) had a positive result. Most active infections (53 [82.8%]) were identified in Maputo. Of all, 54 (84.4%) occurred between June-August 2021, 6 (9.4%) in December 2021-January 2022. No differences were seen in baseline CD4⁺T-cell count or viral load between the three arms (p=0.64 and p=0.07, respectively).
CONCLUSIONS: About one in three PLHIV in this cohort were reported being exposed to SARS-CoV-2; one in 20 were confirmed actively infected with SARS-CoV-2, consistent with timing of COVID-19 epidemic waves in Mozambique. Follow-up of active infection is important to monitor clinical, immunological and virologic HIV-related short and mid-term outcomes.

Download the e-Poster (PDF)