Comparison of classic and novel human astrovirus MLB and VA seroprevalence in HIV and non-HIV cohorts in South China demonstrates high seroreactivity to classic human astrovirus, which is associated with HIV infection

Human astroviruses (HAstVs) are increasingly implicated in severe systemic and neurological infections, yet their seroepidemiology in immunocompromised populations remains poorly characterized. This study provides critical insights into the divergent immune responses to classic and novel HAstV clades among people living with HIV (PLWH) in southern China. We demonstrate that PLWH displayed heightened antibody responses to classic HAstV1 but reduced reactivity to MLB2, suggesting HIV-driven immune dysregulation may selectively boost infection with classic HAstV strains. These findings highlight the need for targeted surveillance and improved diagnostics for HAstV infections in high-risk populations.