Similar Risk of Severe Acute Respiratory Syndrome Coronavirus 2 Infection and Similar Nucleocapsid Antibody Levels in People With Well-Controlled Human Immunodeficiency Virus (HIV) and a Comparable Cohort of People Without HIV

Abstract

Background Within the ongoing AGEhIV Cohort Study in Amsterdam, we prospectively compared the incidence of and risk factors for SARS-CoV-2 infection between HIV-positive and -negative participants. Moreover, we compared SARS-CoV-2 nucleocapsid antibody levels between participants with incident infection from both groups. Methods Starting in September 2020, consenting HIV-positive and HIV-negative participants were assessed 6-monthly for incident SARS-CoV-2 infection, using combined IgA/IgM/IgG SARS-CoV-2 nucleocapsid antibody assay. Cumulative incidence of SARS-CoV-2 infection and associated risk factors were assessed from February 27, 2020 through April 30, 2021 using complementary log-log regression. In those with incident SARS-CoV-2 infection, N-antibody levels were compared between groups using linear regression. Results 241 HIV-positive (99.2% virally suppressed) and 326 HIV-negative AGEhIV participants were included in this study. Cumulative SARS-CoV-2 incidence by April 2021 was 13.4% and 11.6% in HIV-positive and HIV-negative participants, respectively (p=0.61). Younger age and African origin were independently associated with incident infection. In those with incident infection, only self-reported fever, but not HIV status, was associated with higher N-antibody levels. Conclusions HIV-positive individuals with suppressed viremia and adequate CD4 cell counts were had similar risk of SARS-CoV-2 acquisition, and had similar SARS-CoV-2 N-antibody levels following infection compared to a comparable cohort of HIV-negative people.

Post-Acute Sequelae and Adaptive Immune Responses in People Living With Hiv Recovering From Sars-Cov-2 Infection

“…Since the beginning of the pandemic, there has been concern that PWH are less likely to develop and maintain protective immunity. While some studies suggested lower humoral responses in PWH [6], we and others [36][37][38] have not observed this. to a more exhausted phenotype.…”

“…Since the beginning of the pandemic, there has been concern that PWH might be less likely to develop and maintain protective immunity. While some studies suggested lower humoral responses in PWH [14], this did not appear to translate into a higher risk of re-infection in the pre-vaccine era, and several other studies did not find substantial differences following natural infection in PWH on suppressive ART [68][69][70]. Although some early data suggest that vaccine-induced immunity could be less robust among PWH, it appears to be driven by the population of PWH with low CD4+ cell counts [71].…”

Postacute sequelae and adaptive immune responses in people with HIV recovering from SARS-COV-2 infection

“…There is ongoing concern that PWH are less likely to develop and maintain protective immunity. Although some studies suggested lower humoral responses in PWH [6], we and others [36][37][38] have not observed this.…”

Lower SARS-CoV-2–specific humoral immunity in people living with HIV-1 recovered from nonhospitalized COVID-19

“…PLWH in South Africa with well-controlled HIV-1 also demonstrated 6 similar antibody kinetics, durability, and neutralization potency as PWOH (12). Similar antibody levels against the spike protein and nucleocapsid were reported in small PLWH cohorts in Japan (13) and the Netherlands (14), respectively. In contrast, other studies reported a marked decline of antibody responses within 2 months of SARS-CoV-2 infection among PLWH (15) with diminished seroconversion and shorter duration of antibody responses than PWOH (16).…”