SARS-CoV-2 Seropositivity and HIV Viral Load Among Mozambican Pregnant Women

Abstract

Introduction: Prevalence estimates of SARS-CoV-2 infection in Africa are limited, particularly among pregnant women and in those living with HIV. This study assessed the seroprevalence of SARS-CoV-2 antibodies among Mozambican HIV-infected pregnant women during the first year of the pandemic, before COVID-19 vaccines were deployed in the country. Setting: The study was conducted in Manhiça district, a semirural area in southern Mozambique. Methods: A prospective cohort study including pregnant women living with HIV was conducted from November 2019 to June 2021. Women were enrolled at the first antenatal care clinic visit and followed until postpartum. HIV viral load and IgM/IgG antibodies against SARS-CoV-2 were determined in blood samples at first antenatal care clinic visit and at delivery. Associations between SARS-CoV-2 serostatus and maternal characteristics at enrolment were analyzed. Results: A total of 397 women were enrolled. SARS-CoV-2 IgG/IgM antibodies were detected in 7.1% of women at enrolment and in 8.5% of women at delivery. Overall, SARS-CoV-2 antibodies were detected in 45 women (11.3%; 95% confidence interval 8.4 to 14.9%) during the study period; the first seropositive sample was identified in September 2020. Having undetectable HIV viral load was associated with seropositivity of SARS-CoV-2 IgG/IgM [odds ratio 3.35 (1.10 to 11.29); P = 0.039]. Conclusion: Seroprevalence of SARS-CoV-2 antibodies in this cohort of Mozambican unvaccinated pregnant women was similar to reported global estimates of approximately 10% in pregnancy for 2021. The findings also suggest that pregnant women with high HIV viral load may have an impaired immune response against SARS-CoV-2 and might need to be carefully managed in case of COVID-19.

Trends in SARS-CoV-2 seroprevalence among pregnant women attending first antenatal care visits in Zambia: a repeated cross-sectional survey, 2021-2022

“…Antenatal care (ANC) clinics have been utilized in several countries in Africa to monitor SARS-CoV-2 seroprevalence in a healthy population of women accessing healthcare services. [5][6][7][8][9] In Ethiopia, SARS-CoV-2 surveillance conducted in ANC clinics between April 2020 and March 2021 first detected SARS-CoV-2 antibodies in June 2020 and peaked at 11.8% in February 2021. 10 Repeated cross-sectional serosurveys in ANC clinics in Kenya found that most women were seropositive for SARS-CoV-2 antibodies by October 2021.…”

Trends in SARS-CoV-2 seroprevalence among pregnant women attending first antenatal care visits in Zambia: A repeated cross-sectional survey, 2021–2022

“…Repeated cross-sectional surveys leveraging existing healthcare platforms can help monitor trends in seroprevalence during ongoing transmission while minimizing implementation costs associated with large-scale household surveys. Antenatal care (ANC) clinics have been utilized in several countries in Africa to monitor SARS-CoV-2 seroprevalence in a healthy population of women accessing healthcare services [5][6][7][8][9]. In Ethiopia, SARS-CoV-2 surveillance conducted in ANC clinics between April 2020 and March 2021 first detected SARS--CoV-2 antibodies in June 2020 and peaked at 11.8% in February 2021 [10].…”

T-cell responses to ancestral SARS-CoV-2 and Omicron variant among unvaccinated pregnant and postpartum women living with and without HIV in South Africa

“…Given the high HIV burden in sub-Saharan African countries [18], as well as the risks of SARS-CoV-2 infection during pregnancy, it is critical to investigate immune responses to SARS-CoV-2 infection and associated variants in WLWH. Most studies have only compared humoral responses between pregnant and non-pregnant women following SARS-CoV-2 infection or Covid-19 vaccination [13,15,[19][20][21]. However, there is a paucity of information on SARS-CoV-2 cell-mediated immune responses in PWH from low-and middle-income settings [12].…”