{"doi":"10.1371/journal.pgph.0005156","title":"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","abstract":"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.","journal":"PLOS Global Public Health","year":2025,"id":574606,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9635,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":121147,"name":"Shuying Sue Li","orcid":null,"position":1,"is_corresponding":false},{"id":880583,"name":"Jiani Hu","orcid":"0000-0003-1733-6822","position":2,"is_corresponding":false},{"id":347832,"name":"Samuel T. Robinson","orcid":"0000-0003-2356-9905","position":3,"is_corresponding":false},{"id":1209433,"name":"Zaheer Hoosain","orcid":null,"position":4,"is_corresponding":false},{"id":331062,"name":"Nigel Garrett","orcid":"0000-0002-4530-234X","position":5,"is_corresponding":false},{"id":385788,"name":"Zvavahera M. Chirenje","orcid":"0000-0003-3538-5150","position":6,"is_corresponding":false},{"id":773178,"name":"Llewellyn Fleurs","orcid":null,"position":7,"is_corresponding":false},{"id":798189,"name":"Haajira Kaldine","orcid":"0000-0002-7946-5606","position":8,"is_corresponding":false},{"id":874488,"name":"Tandile Modise","orcid":null,"position":9,"is_corresponding":false},{"id":138629,"name":"Penny L. Moore","orcid":"0000-0001-8719-4028","position":10,"is_corresponding":false},{"id":302717,"name":"April K. Randhawa","orcid":"0000-0003-2652-3734","position":11,"is_corresponding":false},{"id":582718,"name":"Anton M. Sholukh","orcid":"0000-0003-0498-9162","position":12,"is_corresponding":false},{"id":302716,"name":"Julia Hütter","orcid":"0000-0002-7989-0450","position":13,"is_corresponding":false},{"id":331743,"name":"Laura Polakowski","orcid":"0000-0002-5476-7632","position":14,"is_corresponding":false},{"id":96348,"name":"Lawrence Corey","orcid":"0000-0002-2179-2436","position":15,"is_corresponding":false},{"id":307186,"name":"Katherine Gill","orcid":"0000-0002-3372-9506","position":16,"is_corresponding":false},{"id":103755,"name":"David C. Montefiori","orcid":"0000-0003-0856-6319","position":17,"is_corresponding":false},{"id":30696,"name":"Holly Janes","orcid":"0000-0002-3237-984X","position":18,"is_corresponding":false},{"id":522324,"name":"Shelly Karuna","orcid":"0000-0001-5946-9733","position":19,"is_corresponding":false},{"id":710765,"name":"for the HVTN 405/HPTN 1901 Study Team","orcid":null,"position":20,"is_corresponding":false},{"id":355225,"name":"Nonhlanhla N. Mkhize","orcid":"0000-0003-3037-1243","position":0,"is_corresponding":true}],"reference_count":50,"raw_metadata":null,"created_at":"2026-07-19T02:57:44.572630Z","pmid":"40934225","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}