Mkhize Nonhlanhla N, Li Shuying Sue, Hu Jiani, Robinson Samuel T, Hoosain Zaheer, Garrett Nigel, Chirenje Zvavahera M, Fleurs Llewellyn, Kaldine Haajira, Modise Tandile, Moore Penny L, Randhawa April K, Sholukh Anton M, Hutter Julia, Polakowski Laura, Corey Lawrence, Gill Katherine, Montefiori David C, Janes Holly, Karuna Shelly
SAMRC Antibody Immunity Research Unit, University of the Witwatersrand, Johannesburg, South Africa.
National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa.
PLOS Glob Public Health. 2025 Sep 11;5(9):e0005156. doi: 10.1371/journal.pgph.0005156. eCollection 2025.
COVID-19 has affected millions worldwide. Research characterized immune responses of individuals who acquired SARS-CoV-2 and identified co-factors, such as HIV, associated with greater likelihood of poor clinical outcomes. SARS-CoV-2-specific neutralizing antibodies (nAbs) are a strong correlate of protection but their elicitation in people living with HIV (PLWH), and particularly in southern Africa, is less well characterized. HVTN 405/HPTN 1901 was an observational cohort study of individuals recently recovered from SARS-CoV-2. We describe 323 participants enrolled early in the pandemic (June 2020 to January 2021) in Zambia (n = 12), Malawi (n = 13), Zimbabwe (n = 59), and South Africa (n = 239), profiling their SARS-CoV-2-specific nAb responses and associations with demographics, comorbidities, disease severity, and time since diagnosis based on linear and logistic regression. Participants' median age was 39 years, 63.5% were assigned female sex at birth, 71.2% were black African, and 39 (12.1%) were PLWH. Approximately one in four participants (25.7%) had asymptomatic SARS-CoV-2, 47.4% were symptomatic but not hospitalized, and 26.9% were hospitalized with COVID-19. Participants in these groups were enrolled at a median of 51.5 days, 53 days, and 60 days post-SARS-CoV-2 diagnosis, respectively. SARS-CoV-2 nAbs were measured in serum using one of two calibrated assays. Most (291/322, 90.4%) participants had positive nAb responses at enrollment. Across all participants, nAb responses generally declined in magnitude between enrollment and 2-3 months thereafter, then increased through month 12 coincident with epidemiologically observed new waves of acquisition. In a multivariate model adjusted for potentially confounding factors, PLWH had a 65% lower geometric mean (GM) nAb ID50 titer compared to people without HIV (PWOH) (GMR: 0.35, p = 0.003, q = 0.006). Greater disease severity, older age (>55 years), high BMI (≥30) and diabetes were associated with higher nAb ID50 titers (all p < 0.05, all q < 0.20).These findings are important, as nAb titers are predictive of vulnerability to COVID-19.
新冠病毒病（COVID-19）已影响全球数百万人。研究对感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的个体的免疫反应进行了特征分析，并确定了与临床预后较差可能性较高相关的共同因素，如艾滋病毒（HIV）。SARS-CoV-2特异性中和抗体（nAbs）是保护作用的有力关联指标，但其在艾滋病毒感染者（PLWH）中，尤其是在非洲南部人群中的激发情况，特征描述较少。HVTN 405/HPTN 1901是一项对近期从SARS-CoV-2感染中康复的个体进行的观察性队列研究。我们描述了在疫情早期（2020年6月至2021年1月）在赞比亚（n = 12）、马拉维（n = 13）、津巴布韦（n = 59）和南非（n = 239）招募的323名参与者，根据线性和逻辑回归分析他们的SARS-CoV-2特异性nAb反应以及与人口统计学、合并症、疾病严重程度和诊断后时间的关联。参与者的年龄中位数为39岁，63.5%出生时被指定为女性，71.2%为非洲黑人，39人（12.1%）为艾滋病毒感染者。大约四分之一的参与者（25.7%）感染SARS-CoV-2后无症状，47.4%有症状但未住院，26.9%因COVID-19住院。这些组中的参与者分别在SARS-CoV-2诊断后的51.5天、53天和60天中位数时入组。使用两种校准检测方法之一在血清中检测SARS-CoV-2 nAbs。大多数（291/322，90.4%）参与者在入组时nAb反应呈阳性。在所有参与者中，nAb反应强度在入组和此后2 - 3个月之间总体下降，然后在第12个月时增加，这与流行病学观察到的新感染浪潮一致。在针对潜在混杂因素进行调整的多变量模型中，与未感染艾滋病毒的人（PWOH）相比，艾滋病毒感染者的几何平均（GM）nAb ID50滴度低65%（几何平均比率：0.35，p = 0.003，q = 0.006）。疾病严重程度更高、年龄较大（>55岁）、高体重指数（≥30）和糖尿病与更高的nAb ID50滴度相关（所有p < 0.05，所有q < 0.20）。这些发现很重要，因为nAb滴度可预测对COVID-19的易感性。
