Neutralizing antibody responses over time in a demographically and clinically diverse cohort of individuals recovered from Sars-CoV-2 acquisition in Africa

A cohort study

Bibliographic Data

ID19593352
AuthorsNonhlanhla N Mkhize (0000-0003-3037-1243, National Health Laboratory Service, corresponding author), Shuying Sue Li (Fred Hutch Cancer Center, corresponding author), Jiani Hu (0000-0002-2928-3169, Fred Hutch Cancer Center, corresponding author), Samuel T Robinson (0000-0003-2356-9905, Fred Hutch Cancer Center, corresponding author), Zaheer Hoosain (corresponding author), Nigel Garrett (0000-0002-4530-234X, Centre for the AIDS Programme of Research in South Africa, corresponding author), Zvavahera M Chirenje (0000-0003-3538-5150, University of Zimbabwe, corresponding author), Llewellyn Fleurs (Desmond Tutu HIV Foundation, corresponding author), Haajira Kaldine (0000-0002-7946-5606, National Health Laboratory Service, corresponding author), Tandile Modise (National Health Laboratory Service, corresponding author), Penny L Moore (0000-0001-8719-4028, National Health Laboratory Service, corresponding author), April K Randhawa (0000-0003-2652-3734, Fred Hutch Cancer Center, corresponding author), Anton M Sholukh (0000-0003-0498-9162, Fred Hutch Cancer Center, corresponding author), Julia Hutter (0000-0002-7989-0450, National Institutes of Health, corresponding author), Laura Polakowski (0000-0002-5476-7632, Duke Medical Center, corresponding author), Lewis Corey (0000-0002-2179-2436, Fred Hutch Cancer Center, corresponding author), Lawrence Corey, Katherine Gill (0000-0002-7174-0888), Katherine M Gill (0000-0002-3372-9506, Desmond Tutu HIV Foundation, corresponding author), David C Montefiori (0000-0003-0856-6319, Duke Medical Center, corresponding author), Holly Janes (0000-0002-3237-984X, Fred Hutch Cancer Center, corresponding author), Shelly Karuna (0000-0001-5946-9733, Fred Hutch Cancer Center, corresponding author), for the HVTN 405/HPTN Study Team
EditorsSanghyuk S Shin Sanghyuk S Shin
Year2025
Volume5
Issue9
Pagese0005156
Publication date2025-09-11
Open AccessYes
TypeARTICLE
VenuePLOS Global Public Health (JOURNAL)
Journal identifiersISSN: 2767-3375 • E-ISSN: 2767-3375
PublisherPublic Library of Science (PLoS) (PUBLISHER)
DOI10.1371/journal.pgph.0005156
PMID40934225
OpenAlexW4414116865
LanguageEN
References cited49

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

Asymptomatic · Cohort · Cohort study · Confounding · Logistic regression · Neutralizing antibody · Observational study · Pandemic · COVID-19 Clinical Research Studies · Long-Term Effects of COVID-19 · SARS-CoV-2 and COVID-19 Research · Epidemiology

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