Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2022
2022
Historique:
received:
18
02
2021
accepted:
22
02
2022
entrez:
18
3
2022
pubmed:
19
3
2022
medline:
4
5
2022
Statut:
epublish
Résumé
Despite high exposure to Mycobacterium tuberculosis, a small proportion of South African goldminers resist TB infection. We determined, among long-service gold miners i) the proportion who were TB uninfected and ii) epidemiological factors associated with being uninfected. We enrolled HIV-negative gold miners aged 33-60 years with ≥15 years' service and no history of TB or silicosis. Miners were defined as TB uninfected if i) QuantiFERON-TB Gold Plus (QFT-Plus) negative or ii) in a stricter definition, QFT-Plus-negative and zero-response on TST and as resisters if they were of Black/African ethnicity and negative on both tests. Logistic regression was used to identify epidemiological factors associated with being TB uninfected. Of 307 participants with a QFT-Plus result, median age was 48 years (interquartile range [IQR] 44-53), median time working underground was 24 years (IQR 18-28), 303 (99%) were male and 91 (30%) were QFT-Plus-negative. The odds of being TB uninfected was 52% lower for unskilled workers (adjusted odds ratio [aOR] 0.48; 95% confidence interval [CI] 0.27-0.85; p = 0.013). Among 281 participants of Black/African ethnicity, 71 (25%) were QFT-Plus negative. Miners with a BMI ≥30 were less likely to be TB uninfected (OR 0.38; 95% CI 0.18-0.80). Using the stricter definition, 44.3% (136/307) of all miners were classified as either TB uninfected (35; 26%) or infected, (101; 74%) and the associations remained similar. Among Black/African miners; 123 were classified as either TB uninfected (23; 19%) or infected (100; 81%) using the stricter definition. No epidemiological factors for being TB uninfected were identified. Despite high cumulative exposure, a small proportion of miners appear to be resistant to TB infection and are without distinguishing epidemiological characteristics.
Sections du résumé
BACKGROUND
Despite high exposure to Mycobacterium tuberculosis, a small proportion of South African goldminers resist TB infection. We determined, among long-service gold miners i) the proportion who were TB uninfected and ii) epidemiological factors associated with being uninfected.
METHODS
We enrolled HIV-negative gold miners aged 33-60 years with ≥15 years' service and no history of TB or silicosis. Miners were defined as TB uninfected if i) QuantiFERON-TB Gold Plus (QFT-Plus) negative or ii) in a stricter definition, QFT-Plus-negative and zero-response on TST and as resisters if they were of Black/African ethnicity and negative on both tests. Logistic regression was used to identify epidemiological factors associated with being TB uninfected.
RESULTS
Of 307 participants with a QFT-Plus result, median age was 48 years (interquartile range [IQR] 44-53), median time working underground was 24 years (IQR 18-28), 303 (99%) were male and 91 (30%) were QFT-Plus-negative. The odds of being TB uninfected was 52% lower for unskilled workers (adjusted odds ratio [aOR] 0.48; 95% confidence interval [CI] 0.27-0.85; p = 0.013). Among 281 participants of Black/African ethnicity, 71 (25%) were QFT-Plus negative. Miners with a BMI ≥30 were less likely to be TB uninfected (OR 0.38; 95% CI 0.18-0.80). Using the stricter definition, 44.3% (136/307) of all miners were classified as either TB uninfected (35; 26%) or infected, (101; 74%) and the associations remained similar. Among Black/African miners; 123 were classified as either TB uninfected (23; 19%) or infected (100; 81%) using the stricter definition. No epidemiological factors for being TB uninfected were identified.
CONCLUSIONS
Despite high cumulative exposure, a small proportion of miners appear to be resistant to TB infection and are without distinguishing epidemiological characteristics.
Identifiants
pubmed: 35302992
doi: 10.1371/journal.pone.0265036
pii: PONE-D-21-05516
pmc: PMC8932619
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0265036Subventions
Organisme : Medical Research Council
ID : MR/R010161/1
Pays : United Kingdom
Organisme : NIAID NIH HHS
ID : UM1 AI154463
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Nat Rev Immunol. 2018 Sep;18(9):575-589
pubmed: 29895826
Lancet Infect Dis. 2004 Dec;4(12):761-76
pubmed: 15567126
Am J Epidemiol. 2015 Apr 15;181(8):619-32
pubmed: 25792607
Clin Infect Dis. 2019 May 2;68(10):1705-1712
pubmed: 30165605
JAMA. 1995 Jul 12;274(2):143-8
pubmed: 7596002
PLoS One. 2017 Apr 17;12(4):e0175844
pubmed: 28414762
Am J Epidemiol. 2018 Jul 1;187(7):1477-1489
pubmed: 29304247
PLoS One. 2008;3(12):e4094
pubmed: 19116662
PLoS Med. 2016 Oct 25;13(10):e1002152
pubmed: 27780211
J Clin Invest. 2021 Jul 15;131(14):
pubmed: 34111032
Ann Intern Med. 2008 Aug 5;149(3):177-84
pubmed: 18593687
N Engl J Med. 2014 Jan 23;370(4):301-10
pubmed: 24450889
Occup Environ Med. 1998 Jul;55(7):496-502
pubmed: 9816385
AIDS. 2000 Dec 1;14(17):2759-68
pubmed: 11125895
Int J Tuberc Lung Dis. 2009 Jan;13(1):39-46
pubmed: 19105877
Nat Rev Microbiol. 2009 Dec;7(12):845-55
pubmed: 19855401
Arch Intern Med. 2003 May 12;163(9):1009-21
pubmed: 12742798
PLoS One. 2019 Jul 18;14(7):e0218034
pubmed: 31318864
Int J Tuberc Lung Dis. 2000 Aug;4(8):705-12
pubmed: 10949321
Occup Environ Med. 2006 Mar;63(3):187-92
pubmed: 16497860
Am J Respir Crit Care Med. 1994 Nov;150(5 Pt 1):1460-2
pubmed: 7952577
Int J Tuberc Lung Dis. 2012 Jul;16(7):967-73
pubmed: 22584100
BMC Infect Dis. 2014 Jun 27;14:352
pubmed: 24970328
Front Microbiol. 2016 May 17;7:669
pubmed: 27242697