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Meiring, Susan; Tempia, Stefano; Bhiman, Jinal N; Buys, Amelia; Kleynhans, Jackie; Makhasi, Mvuyo; McMorrow, Meredith; Moyes, Jocelyn; Quan, Vanessa; Walaza, Sibongile; du Plessis, Mignon; Wolter, Nicole; von Gottberg, Anne; Cohen, Cheryl; Black, John; Goedhals, Dominique; Maloba, Bonnie; Potgieter, Samantha; Black, Marianne; Chibabhai, Vindana; Mbenenge, Nonhlanhla; Nana, Trusha; Stacey, Sarah; Treurnicht, Florette; [...]

Prolonged Shedding of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at High Viral Loads Among Hospitalized Immunocompromised Persons Living With Human Immunodeficiency Virus (HIV), South Africa

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  • Media type: E-Article
  • Title: Prolonged Shedding of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at High Viral Loads Among Hospitalized Immunocompromised Persons Living With Human Immunodeficiency Virus (HIV), South Africa
  • Contributor: Meiring, Susan; Tempia, Stefano; Bhiman, Jinal N; Buys, Amelia; Kleynhans, Jackie; Makhasi, Mvuyo; McMorrow, Meredith; Moyes, Jocelyn; Quan, Vanessa; Walaza, Sibongile; du Plessis, Mignon; Wolter, Nicole; von Gottberg, Anne; Cohen, Cheryl; Black, John; Goedhals, Dominique; Maloba, Bonnie; Potgieter, Samantha; Black, Marianne; Chibabhai, Vindana; Mbenenge, Nonhlanhla; Nana, Trusha; Stacey, Sarah; Treurnicht, Florette; [...]
  • Published: Oxford University Press (OUP), 2022
  • Published in: Clinical Infectious Diseases, 75 (2022) 1, Seite e144-e156
  • Language: English
  • DOI: 10.1093/cid/ciac077
  • ISSN: 1058-4838; 1537-6591
  • Origination:
  • Footnote:
  • Description: Abstract Background We assessed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA shedding duration and magnitude among persons living with human immunodeficiency virus (HIV, PLHIV). Methods From May through December 2020, we conducted a prospective cohort study at 20 hospitals in South Africa. Adults hospitalized with symptomatic coronavirus disease 2019 (COVID-19) were enrolled and followed every 2 days with nasopharyngeal/oropharyngeal (NP/OP) swabs until documentation of cessation of SARS-CoV-2 shedding (2 consecutive negative NP/OP swabs). Real-time reverse transcription-polymerase chain reaction testing for SARS-CoV-2 was performed, and cycle-threshold (Ct) values < 30 were considered a proxy for high SARS-CoV-2 viral load. Factors associated with prolonged shedding were assessed using accelerated time-failure Weibull regression models. Results Of 2175 COVID-19 patients screened, 300 were enrolled, and 257 individuals (155 HIV-uninfected and 102 PLHIV) had > 1 swabbing visit (median 5 visits [range 2–21]). Median time to cessation of shedding was 13 days (interquartile range [IQR] 6–25) and did not differ significantly by HIV infection. Among a subset of 94 patients (41 PLHIV and 53 HIV-uninfected) with initial respiratory sample Ct-value < 30, median time of shedding at high SARS-CoV-2 viral load was 8 days (IQR 4–17). This was significantly longer in PLHIV with CD4 count < 200 cells/µL, compared to HIV-uninfected persons (median 27 days [IQR 8–43] vs 7 days [IQR 4–13]; adjusted hazard ratio [aHR] 0.14, 95% confidence interval [CI] .07–.28, P < .001), as well as in unsuppressed-HIV versus HIV-uninfected persons. Conclusions Although SARS-CoV-2 shedding duration did not differ significantly by HIV infection, among a subset with high initial SARS-CoV-2 viral loads, immunocompromised PLHIV shed SARS-CoV-2 at high viral loads for longer than HIV-uninfected persons. Better HIV control may potentially decrease transmission time of SARS-CoV-2.
  • Access State: Open Access