SARS-CoV-2 seroprevalence in people living with HIV in South Sudan

Helen M Chun; Dennis K Lodiongo; Kyle Milligan; Grace J Lesuk; Divya Patel; Ray W Shiraishi; Diana Martin; Ashley K Simon; Emilio Dirlikov; Hetal K Patel; Dennis Ellenberger; Habtamu A Worku; Yen T Duong; Robert O Ekong; Joel S Katoro; Shambel A Hussen; Michael L Lokore; Gregory Wani; Sudhir Bunga

doi:10.1016/j.ijregi.2024.100421

SARS-CoV-2 seroprevalence in people living with HIV in South Sudan

IJID Reg. 2024 Aug 8:12:100421. doi: 10.1016/j.ijregi.2024.100421. eCollection 2024 Sep.

Authors

Helen M Chun¹, Dennis K Lodiongo², Kyle Milligan^{1

3}, Grace J Lesuk⁴, Divya Patel¹, Ray W Shiraishi¹, Diana Martin⁵, Ashley K Simon⁵, Emilio Dirlikov⁶, Hetal K Patel¹, Dennis Ellenberger¹, Habtamu A Worku⁴, Yen T Duong⁷, Robert O Ekong⁴, Joel S Katoro², Shambel A Hussen⁴, Michael L Lokore⁸, Gregory Wani⁸, Sudhir Bunga²

Affiliations

¹ Division of Global HIV & Tuberculosis, Global Health Center, Centers for Disease Control and Prevention, Atlanta, USA.
² Division of Global HIV & Tuberculosis, Global Health Center, Centers for Disease Control and Prevention, Juba, South Sudan.
³ Peraton Inc., Herndon, USA.
⁴ ICAP at Columbia University, Juba, South Sudan.
⁵ Division of Parasitic Diseases and Malaria, Global Health Center, Centers for Disease Control and Prevention, Atlanta, USA.
⁶ Division of Global HIV & Tuberculosis, Global Health Center, Centers for Disease Control and Prevention, Maputo, Mozambique.
⁷ ICAP at Columbia University, New York, USA.
⁸ Public Health Laboratory, Ministry of Health, Juba, South Sudan.

Abstract

Objectives: The burden of SARS-CoV-2 infection in people living with HIV (PLHIV) in South Sudan is unknown.

Methods: We conducted a cross-sectional seroprevalence survey of SARS-CoV-2 immunoglobulin (Ig) G antibodies and other diseases of public health importance (strongyloidiasis, toxoplasmosis) in PLHIV in South Sudan during April 1, 2020-April 30, 2022. We used a multiplex SARS-CoV-2 immunoassay to detect IgG antibodies targeting the SARS-CoV-2 spike, receptor binding domain, and nucelocapsid (N) proteins, and antigens for other pathogens (Strongyloides stercoralis and Toxoplasma gondii).

Results: Among 3518 samples tested, seroprevalence of IgG antibodies to SARS-CoV-2 spike protein and receptor binding domain 591 and nucleocapsid ranged from 1.4% (95% confidence interval [CI]: 0.9-2.1%) in April-June 2020 to 53.3% (95% CI: 49.5-57.1%) in January-March 2022. The prevalence of S. stercoralis IgG ranged between 27.3% (95% CI: 23.4-31.5%) in October-December 2021 and 47.2% (95% CI: 37.8-56.8%) in July-September 2021, and, for T. gondii IgG, prevalence ranged from 15.5% (95% CI: 13.3-17.9%) in April-June 2020 to 36.2% (95% CI: 27.4-46.2%) July-September 2021.

Conclusions: By early 2022, PLHIV in South Sudan had high rates of SARS-CoV-2 seropositivity. Surveillance of diseases of global health concern in PLHIV is crucial to estimate population-level exposure and inform public health responses.

Keywords: COVID-19; People living with HIV; SARS-CoV-2; Seroprevalence.