Secretaria Municipal de Saúde, Santo André, São Paulo, Brazil.
Universidade do Estado de São Paulo, Campus Botucatu, Botucatu, São Paulo, Brazil.
Rev Inst Med Trop Sao Paulo. 2022 Feb 2;64:e3. doi: 10.1590/S1678-9946202264003. eCollection 2022.
The COVID-19 pandemic in Brazil has been marked by high infection and death rates. The immune response generated by current vaccination might be influenced by previous natural infection, and baseline estimates may help in the evaluation of vaccine-induced serological response. We evaluated previous SARS-CoV-2 testing (RT-PCR), and performed rapid diagnostic tests (RDT) and high throughput electrochemiluminescence immunoassay (ECLIA) before vaccination among people living with HIV (PLWH), users of antiretroviral prophylaxis (PrEP/PEP), and healthcare professionals in an HIV outpatient clinic (HCP-HC). RDT was positive in 25.7% (95% CI: 19-33%) overall, 31.3% (95% CI : 18-45%) among PLWH, 23.7% (95% CI : 14-34%) in PrEP/PEP users and 21.4% (95% CI : 05-28%) in HCP-HC (p=0.548). Diagnostic RT-PCR testing was very limited, even for symptomatic individuals, and whereas all HCP-HC had one test perfomed, only 35% of the patients (PREP/PEP/PLWH) were tested (p<0.0001). Adequate monitoring of post-vaccination humoral response and breakthrough infections including those in asymptomatic cases are warranted, especially in immunologically compromised individuals.
巴西的 COVID-19 大流行的特点是高感染率和死亡率。当前疫苗接种所产生的免疫反应可能受到先前自然感染的影响，而基线估计可能有助于评估疫苗诱导的血清学反应。我们评估了在艾滋病毒门诊诊所（HCP-HC）中接受 HIV 感染的人（PLWH）、接受抗逆转录病毒预防（PrEP/PEP）的人以及卫生保健专业人员在接种疫苗之前的 SARS-CoV-2 检测（RT-PCR）、快速诊断检测（RDT）和高通量电化学发光免疫分析（ECLIA）的情况。总体而言，RDT 阳性率为 25.7%（95%CI：19-33%），PLWH 中为 31.3%（95%CI：18-45%），PrEP/PEP 使用者中为 23.7%（95%CI：14-34%），HCP-HC 中为 21.4%（95%CI：05-28%）（p=0.548）。诊断性 RT-PCR 检测非常有限，即使是针对有症状的个体，而且尽管所有 HCP-HC 都进行了一次检测，但只有 35%的患者（PrEP/PEP/PLWH）接受了检测（p<0.0001）。有必要对疫苗接种后体液反应和突破感染进行适当监测，包括无症状病例，特别是在免疫功能受损的个体中。
