Dataset Information

Household transmission of SARS-CoV-2 from adult index cases living with and without HIV in South Africa, 2020-2021: a case-ascertained, prospective observational household transmission study.

ABSTRACT:

Background

In South Africa, 19% of the adult population are living with HIV (LWH). Few data on the influence of HIV on SARS-CoV-2 household transmission are available.

Methods

We performed a case-ascertained, prospective household transmission study of symptomatic index SARS-CoV-2 cases LWH and HIV-uninfected adults and their contacts in South Africa, October 2020 to September 2021. Households were followed up thrice weekly for 6 weeks to collect nasal swabs for SARS-CoV-2 testing. We estimated household cumulative infection risk (HCIR) and duration of SARS-CoV-2 positivity (at cycle threshold value <30 as proxy for high viral load).

Results

We recruited 131 index cases and 457 household contacts. HCIR was 59% (220/373); not differing by index HIV status (60% [51/85] in cases LWH vs 58% [163/279] in HIV-uninfected cases, OR 1.0, 95%CI 0.4-2.3). HCIR increased with index case age (35-59 years: aOR 3.4 95%CI 1.5-7.8 and ≥60 years: aOR 3.1, 95%CI 1.0-10.1) compared to 18-34 years, and contacts' age, 13-17 years (aOR 7.1, 95%CI 1.5-33.9) and 18-34 years (aOR 4.4, 95%CI 1.0-18.4) compared to <5 years. Mean positivity duration at high viral load was 7 days (range 2-17), with longer positivity in cases LWH (aHR 0.4, 95%CI 0.1-0.9).

Conclusions

Index HIV status was not associated with higher HCIR, but cases LWH had longer positivity duration at high viral load. Adults aged >35 years were more likely to transmit, individuals aged 13-34 to acquire SARS-CoV-2 in the household. As HIV infection may increase transmission, health services must maintain HIV testing and antiretroviral therapy initiation.

SUBMITTER: Kleynhans J

PROVIDER: S-EPMC9384657 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Household Transmission of Severe Acute Respiratory Syndrome Coronavirus 2 From Adult Index Cases With and Without Human Immunodeficiency Virus in South Africa, 2020-2021: A Case-Ascertained, Prospective, Observational Household Transmission Study.

Kleynhans Jackie J Walaza Sibongile S Martinson Neil A NA Neti Mzimasi M von Gottberg Anne A Bhiman Jinal N JN Toi Dylan D Amoako Daniel G DG Buys Amelia A Ndlangisa Kedibone K Wolter Nicole N Genade Leisha L Maloma Lucia L Chewparsad Juanita J Lebina Limakatso L de Gouveia Linda L Kotane Retshidisitswe R Tempia Stefano S Cohen Cheryl C

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20230201 3

<h4>Background</h4>In South Africa, 19% of adults are living with human immunodeficiency virus (HIV; LWH). Few data on the influence of HIV on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) household transmission are available.<h4>Methods</h4>We performed a case-ascertained, prospective household transmission study of symptomatic adult index SARS-CoV-2 cases LWH and not living with HIV (NLWH) and their contacts from October 2020 to September 2021. Households were followed up 3 time ...[more]

PMID: 35925613

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