SARS-CoV-2 IgG seropositivity among people living with and without HIV in the first year of the COVID-19 pandemic in Haiti and Tanzania

Background People living with HIV (PLWH) may have compromised humoral immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), potentially influencing susceptibility to infection. Parallel comparative analyses of SARS-CoV-2 seropositivity and antibody levels was conducted among adults with and without HIV in Port-au-Prince, Haiti and in Mwanza, Tanzania early in the COVID-19 pandemic (2020-2021). Methods In Haiti, participants were recruited from ongoing studies including a community-based study of cardiovascular disease, a cohort of adults living with HIV and a cohort with a history of tuberculosis. In Tanzania, participants were recruited from a cohort of adults with and without HIV. Demographic and clinical information was abstracted from electronic medical records. In Haiti, two blood samples were collected six months apart, at baseline and follow-up between September 2020 and September 2021. In Tanzania, a single blood sample was collected (August 2020-May 2021). Anti-SARS-CoV-2 antibodies were measured using the R&D COVID-SeroIndex, Kantaro kit. Results In Haiti, 383 PLWH and 484 HIV-uninfected individuals were enrolled. In Tanzania, 128 PLWH and 142 HIV-uninfected were enrolled. In Haiti, overall SARS-CoV-2 positivity was lower among PLWH than HIV-uninfected (52.5% vs 65.0%; p <0.001). IgG levels were also lower in PLWH (p <0.001), with similar trends observed in the Tanzanian cohort (27.3% vs. 51.4%). Conclusion PLWH in Haiti and Tanzania had lower SARS-CoV-2 seropositivity and lower antibody levels than HIV-uninfected individuals, suggesting some PLWH may mount weaker antibody responses to SARS-CoV-2.