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CME Credit Offered
CME Credit Offered
Abstract Award
Abstract Award
Recording available 2/16-5/2
Recording available 2/16-5/2
AIUM Credit
AIUM Credit
Foundation Awardee
Foundation Awardee
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Abstract Award
Abstract Award
Foundation Awardee
Foundation Awardee

Poster Session 4

Category: Public Health/Global Health

Poster Session 4

(1049) Effect of HIV status on cord blood SARS CoV-2 seropositivity among pregnant women in Zambia

Thursday, February 12, 2026
3:30 PM - 5:00 PM  
Foundation Awardee
Objective:
Both pregnancy and HIV are known risk factors for severe COVID-19 disease, yet data from Africa, where the majority of women living with HIV reside, are lacking. We examined whether HIV affected the incidence of SARS CoV-2 cord blood antibodies during the first years of the pandemic in Zambia.

Study Design:
We leveraged a prospective observational cohort of pregnant women living with and without HIV and receiving care at an urban clinic in Lusaka, Zambia. Of those with HIV, most were on CART preconception and had CD4 counts >350 cell/mm3; about half had an undetectable viral load. Banked cord blood specimens were tested for SARS CoV-2 antibodies to spike and nucleocapsid proteins (Euroimmune ELISA, Lubeck, Germany); those positive for both were presumed to have had a maternal COVID-19 infection. We examined the association of HIV with evidence of COVID infection in two groups: deliveries occurring during the first year of the pandemic and deliveries after vaccine introduction until study completion in November 2022.

Results:
From April 2020 to March 2021, 317 umbilical cord blood samples (186 HIV+/131 HIV-) were tested for SARS CoV-2 antibodies. 28 (8.8%) showed evidence of prior COVID-19 infection; there was no difference by HIV status (9.1 v 8.4% p=0.82). Following introduction of the COVID vaccine, 618 cord blood samples (318 HIV+/300 HIV-) were tested. Overall, 48% showed evidence of infection and 25% vaccination without infection. During this period, cord blood from women living with HIV was less likely to show evidence of infection (41.6 v 54.1%, p< 0.01) and more likely to show evidence of active immunity (29.8 v 19.1%, p< 0.01).    

Conclusion:
In a pregnant cohort with mostly well-controlled HIV infection in Zambia, HIV status did not affect the risk of COVID infection during the first year of the pandemic. SARS CoV-2 seropositivity rose dramatically after the first year, and pregnant women living with HIV were less likely to have evidence of prior COVID infection, possibly related to higher rates of vaccination.