| Title: |
Resistance to tuberculin skin test/interferon-gamma release assay conversion among highly TB exposed, HIV infected goldminers in South Africa |
| Authors: |
Ntshiqa, Thobani; Velen, Kavindhran; Ginindza, Sibuse; Nhlangulela, Lindiwe; Charalambous, Salome; Hawn, Thomas R.; Churchyard, Gavin; Boom, W. Henry; Chihota, Violet; Wallis, Robert |
| Contributors: |
Wang, Mao-Shui; The National Institutes of Health |
| Source: |
PLOS One ; volume 20, issue 5, page e0318819 ; ISSN 1932-6203 |
| Publisher Information: |
Public Library of Science (PLoS) |
| Publication Year: |
2025 |
| Collection: |
PLOS Publications (via CrossRef) |
| Description: |
Background A small proportion of goldminers in South Africa resist tuberculin skin test (TST)/interferon-gamma release assay (IGRA) conversion despite high rates of HIV and prolonged exposure to TB. We conducted a study among HIV-infected goldminers to determine the: i) proportion who resisted TST/IGRA conversion and ii) epidemiological factors associated with resistance to TST/IGRA conversion. Methods We enrolled HIV-infected goldminers who were on antiretroviral treatment, aged 33–60 years, with ≥15 years’ service, no prior or current TB, no silicosis, and with body mass index >18.5 kg/m 2 . TST/IGRA conversion was assessed at baseline, 6 months, and 12 months using TST and QuantiFERON-TB-Gold-Plus (QFT-Plus). Miners were considered resisters if they had a zero TST response and a negative QFT-Plus at all visits. Logistic regression was used to identify epidemiological factors associated with TST/IGRA conversion resistance. Results We enrolled 245 HIV-infected miners with median age of 48 years (interquartile-range [IQR]: 44–52 years) and median CD4 count, 506 cells/ µ L (IQR: 372–677 cells/ µ L). Overall, 98.4% (241) were males and 99.2% (243) were Black/African with a median time of 24 years (IQR: 18–29 years) in the workforce. Of those completing all follow-ups, 24.3% (50/206) resisted TST/IGRA conversion. Miners who had a history of taking isoniazid preventive therapy (IPT) (adjusted odds ratio (aOR) 2.34; 95% confidence interval (CI): 1.14–4.80; p = 0.020) were more likely to resist TST/IGRA conversion. However, those from Mozambique (aOR 0.16; 95% CI: 0.04–0.71; p = 0.016) and those who had a CD4 count ≥500 cells/ µ L (aOR 0.46; 95% CI: 0.23–0.92; p = 0.028) were less likely to resist TST/IGRA conversion. Conclusion Similar to previous longitudinal cohort studies, we found a small proportion of HIV-infected goldminers who resisted TST/IGRA conversion. This was positively associated with prior IPT, but negatively associated with lower CD4 count and being from Mozambique. However, mechanisms underlying ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1371/journal.pone.0318819 |
| Availability: |
https://doi.org/10.1371/journal.pone.0318819; https://dx.plos.org/10.1371/journal.pone.0318819 |
| Rights: |
http://creativecommons.org/licenses/by/4.0/ |
| Accession Number: |
edsbas.528CBC88 |
| Database: |
BASE |