{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T18:17:16Z","timestamp":1760552236593,"version":"3.40.5"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T00:00:00Z","timestamp":1746748800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"The National Institutes of Health","doi-asserted-by":"crossref","award":["R01 AI124348"],"award-info":[{"award-number":["R01 AI124348"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"The National Institutes of Health","doi-asserted-by":"crossref","award":["R01 AI124348"],"award-info":[{"award-number":["R01 AI124348"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000002","name":"The National Institutes of Health","doi-asserted-by":"crossref","award":["R01 AI124348"],"award-info":[{"award-number":["R01 AI124348"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec023\">\n<jats:title>Background<\/jats:title>\n<jats:p>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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec024\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We enrolled HIV-infected goldminers who were on antiretroviral treatment, aged 33\u201360 years, with \u226515 years\u2019 service, no prior or current TB, no silicosis, and with body mass index &gt;18.5\u2009kg\/m<jats:sup>2<\/jats:sup>. 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.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec025\">\n<jats:title>Results<\/jats:title>\n<jats:p>We enrolled 245 HIV-infected miners with median age of 48 years (interquartile-range [IQR]: 44\u201352 years) and median CD4 count, 506 cells\/\u2009\u00b5\u2009L (IQR: 372\u2013677 cells\/\u2009\u00b5\u2009L). Overall, 98.4% (241) were males and 99.2% (243) were Black\/African with a median time of 24 years (IQR: 18\u201329 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\u20134.80; p\u2009=\u20090.020) were more likely to resist TST\/IGRA conversion. However, those from Mozambique (aOR 0.16; 95% CI: 0.04\u20130.71; p\u2009=\u20090.016) and those who had a CD4 count \u2265500 cells\/\u2009\u00b5\u2009L (aOR 0.46; 95% CI: 0.23\u20130.92; p\u2009=\u20090.028) were less likely to resist TST\/IGRA conversion.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec026\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>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 TST\/IGRA conversion resistance are not well understood.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0318819","type":"journal-article","created":{"date-parts":[[2025,5,9]],"date-time":"2025-05-09T17:36:22Z","timestamp":1746812182000},"page":"e0318819","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Resistance to tuberculin skin test\/interferon-gamma release assay conversion among highly TB exposed, HIV infected goldminers in South Africa"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0752-3192","authenticated-orcid":true,"given":"Thobani","family":"Ntshiqa","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kavindhran","family":"Velen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sibuse","family":"Ginindza","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lindiwe","family":"Nhlangulela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Salome","family":"Charalambous","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas R.","family":"Hawn","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin","family":"Churchyard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W. Henry","family":"Boom","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Violet","family":"Chihota","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Wallis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,5,9]]},"reference":[{"key":"pone.0318819.ref001","volume-title":"Global tuberculosis report 2023","author":"WHO","year":"2023"},{"issue":"10","key":"pone.0318819.ref002","article-title":"The Global Burden of Latent Tuberculosis Infection: A Re-estimation Using Mathematical Modelling","volume":"13","author":"RMGJ Houben","year":"2016","journal-title":"PLoS Med"},{"issue":"8","key":"pone.0318819.ref003","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1093\/aje\/kwu320","article-title":"Tuberculosis control in South African gold mines: mathematical 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