key: cord-0843522-an4ktxz0
authors: Papalini, Chiara; Paciosi, Francesco; Schiaroli, Elisabetta; Pierucci, Sara; Busti, Chiara; Bozza, Silvia; Mencacci, Antonella; Francisci, Daniela
title: Seroprevalence of anti-SARS-CoV2 Antibodies in Umbrian Persons Living with HIV
date: 2020-11-01
journal: Mediterr J Hematol Infect Dis
DOI: 10.4084/mjhid.2020.080
sha: 86a45ef5e9d5fbd67ae5fcbf2a5211b4b2b2493b
doc_id: 843522
cord_uid: an4ktxz0

nan

Since the COVID-19 pandemic spread worldwide, great interest has been focused on persons living with HIV (PLWH). The possibility that these two infections act synergically 1 and the opinion that antiretroviral treatment could be a protective factor against new coronavirus 2 animated scientific debate in the last months. Nevertheless, there is still a paucity of literature about COVID-19 among PLWH. Our study represents a small contribution to fill the gap. However, it is limited because Umbria is a 900000-inhabitants Italian region with a low SARS-CoV2 endemicity. 3 On May 4, the Italian government put an end to the lockdown period and started a serological campaign to detect antibodies against SARS-CoV2 for epidemiological scope. Taking a cue from that initiative, we tried to estimate the seroprevalence of anti-SARS-CoV2 antibodies among PLWH visited in the Infectious Diseases Clinic of Perugia teaching hospital where the majority of Umbrian PLWH is in charge. For this purpose, we considered the period from 4 th to May 31 because it was the time-lapse immediately after pandemic acme.

The serological assays' appeal is because their use could have a dual purpose: to confirm an RT-PCR negative suspected case or surveillance and epidemiological aim. To make it possible are necessary high sensitivity and specificity. The best test with these characteristics is still to clarify, hence our decision to use two different serological assays. According to what was available in our hospital, we proposed SCREEN® test COVID-19 (Screen Italia, Torgiano, Perugia, Italy) as a rapid preliminary test. It is a lateral flow chromatographic immunoassay for the qualitative detection of IgM/IgG against SARS-CoV2 and needs a fingerstick whole blood specimen. Manufacturers reported an accuracy of 98.6% for IgG antibodies (sensitivity 95% CI: 86-100%; specificity 95% CI: 89. 4 Taken from a total amount of 2907 HIV-seronegative individuals tested in the mentioned period, we considered, as a control group, 2843 persons within the same range of age as PLWH and 153/2843 (5.4%) resulted in IgG positive to SCREEN® test. Among them, 111 (72.5%) had an RT-PCR negative nasopharyngeal swab, 4 an indeterminate one, 31 were positive, or had the evidence of a positive result in the past weeks while for 7 no RT-PCR test was available. For 50 sera, it has been possible to test also ARCHITECT SARS-CoV-2 IgG ® : 41 (82%) was confirmed positive.

Translating these results on the global number of persons tested, we may estimate that about 4% of Umbrian inhabitants tested had IgG antibodies against SARS-CoV2 during the 4 th -31 st May period.

On the other hand, nobody of the 270 PLWH analyzed had a serologically confirmed infection by SARS-CoV2, independently from their risk factors such as male sex, older age, smoking habit, co-morbidities. 6, 7 This result was in agreement with similar Thai findings. 2 However, in contrast with our Thai colleagues and supported by Italian data about co-infected patients, either antibody positive either slab RT-PCR test positive, 8 we do not believe that ART, and in particular, PIs, had a protective role. In light of our results, just a minority of patients assumed that kind of drug. Furthermore, the efficacy of PIs administration against SARS-CoV2 infection has not been proven. 9 On the contrary, we may speculate that Umbrian PLWHs have been vigilant because they perceived themselves to be at higher risk or that imposed social isolation could have found an ally in the stigma related to HIV infection. It is still premature to understand if that self-isolation has severely damaged the continuum of care.

Chiara Papalini 1 , Francesco Paciosi 1 , Elisabetta Schiaroli 1 , Sara Pierucci 1 , Chiara Busti 1 , Silvia Bozza 2 , Antonella Mencacci 2 and Daniela Francisci 1 .

The Burden of COVID-19 in People Living with HIV: A Syndemic Perspective

SARS-CoV-2 and HIV

Performance characteristics of four high-throughput immunoassays for detection of IgG antibodies against SARS-CoV-2

Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis

Zhong NS; China Medical Treatment Expert Group for Covid-19. Clinical Characteristics of Coronavirus Disease 2019 in China

Smoking is Associated with COVID-19 Progression: A Meta-Analysis

SARS-CoV-2 infection in persons living with HIV: a single center prospective cohort

A Trial of Lopinavir-Ritonavir in Adults Hospitalized with Severe COVID-19