Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa.
BACKGROUND:The increased susceptibility to latent tuberculosis infection (LTBI) of HIV-1-infected persons represents a challenge in TB epidemic control. However few studies have evaluated LTBI predictors in a generalized HIV/TB epidemic setting. METHODS:The study recruited 335 HIV-infected participa...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3467259?pdf=render |
| _version_ | 1818137648773988352 |
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| author | Tolu Oni Hannah P Gideon Nonzwakazi Bangani Relebohile Tsekela Ronnett Seldon Kathryn Wood Katalin A Wilkinson Rene T Goliath Tom H M Ottenhoff Robert J Wilkinson |
| author_facet | Tolu Oni Hannah P Gideon Nonzwakazi Bangani Relebohile Tsekela Ronnett Seldon Kathryn Wood Katalin A Wilkinson Rene T Goliath Tom H M Ottenhoff Robert J Wilkinson |
| author_sort | Tolu Oni |
| collection | DOAJ |
| description | BACKGROUND:The increased susceptibility to latent tuberculosis infection (LTBI) of HIV-1-infected persons represents a challenge in TB epidemic control. However few studies have evaluated LTBI predictors in a generalized HIV/TB epidemic setting. METHODS:The study recruited 335 HIV-infected participants from Khayelitsha, Cape Town between February 2008 and November 2010. Tuberculin skin tests and interferon-gamma release assays were performed on all participants and active TB excluded using a symptom screen, TB microscopy and culture. RESULTS:LTBI prevalence was 52.7% and 61.2% (TST and IGRA respectively). Being a recent TB contact (OR 2.07; 95% C.I. 1.15-3.69) was associated with TST positivity. Participants with a CD4>200 had a two-fold higher risk of IGRA positivity compared to those with CD4 counts <200 (OR 2.07; 95% C.I. 0.99-4.34). There was also a 19% increase in IGRA positivity risk for every additional year of schooling and a strong association between years of schooling and employment (p = 0.0004). A decreased risk of IGRA positivity was observed in persons with a BCG scar (OR 0.46; 95% C.I. 0.31-0.69) and in smokers (OR 0.47; 95% C.I. 0.23-0.96). CONCLUSION:We report the novel findings of a decreased risk of IGRA positivity in HIV-infected smokers possibly due to decreased interferon production, and in the persons with a BCG scar suggesting a protective role for BCG in this population. We also found an increased risk of TST positivity in employed persons, possibly due to ongoing transmission in public modes of transport. |
| first_indexed | 2024-12-11T09:59:39Z |
| format | Article |
| id | doaj.art-b60987871dbc4196892bf2c7ee7f4d4b |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T09:59:39Z |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-b60987871dbc4196892bf2c7ee7f4d4b2022-12-22T01:12:10ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01710e4707210.1371/journal.pone.0047072Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa.Tolu OniHannah P GideonNonzwakazi BanganiRelebohile TsekelaRonnett SeldonKathryn WoodKatalin A WilkinsonRene T GoliathTom H M OttenhoffRobert J WilkinsonBACKGROUND:The increased susceptibility to latent tuberculosis infection (LTBI) of HIV-1-infected persons represents a challenge in TB epidemic control. However few studies have evaluated LTBI predictors in a generalized HIV/TB epidemic setting. METHODS:The study recruited 335 HIV-infected participants from Khayelitsha, Cape Town between February 2008 and November 2010. Tuberculin skin tests and interferon-gamma release assays were performed on all participants and active TB excluded using a symptom screen, TB microscopy and culture. RESULTS:LTBI prevalence was 52.7% and 61.2% (TST and IGRA respectively). Being a recent TB contact (OR 2.07; 95% C.I. 1.15-3.69) was associated with TST positivity. Participants with a CD4>200 had a two-fold higher risk of IGRA positivity compared to those with CD4 counts <200 (OR 2.07; 95% C.I. 0.99-4.34). There was also a 19% increase in IGRA positivity risk for every additional year of schooling and a strong association between years of schooling and employment (p = 0.0004). A decreased risk of IGRA positivity was observed in persons with a BCG scar (OR 0.46; 95% C.I. 0.31-0.69) and in smokers (OR 0.47; 95% C.I. 0.23-0.96). CONCLUSION:We report the novel findings of a decreased risk of IGRA positivity in HIV-infected smokers possibly due to decreased interferon production, and in the persons with a BCG scar suggesting a protective role for BCG in this population. We also found an increased risk of TST positivity in employed persons, possibly due to ongoing transmission in public modes of transport.http://europepmc.org/articles/PMC3467259?pdf=render |
| spellingShingle | Tolu Oni Hannah P Gideon Nonzwakazi Bangani Relebohile Tsekela Ronnett Seldon Kathryn Wood Katalin A Wilkinson Rene T Goliath Tom H M Ottenhoff Robert J Wilkinson Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa. PLoS ONE |
| title | Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa. |
| title_full | Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa. |
| title_fullStr | Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa. |
| title_full_unstemmed | Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa. |
| title_short | Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa. |
| title_sort | smoking bcg and employment and the risk of tuberculosis infection in hiv infected persons in south africa |
| url | http://europepmc.org/articles/PMC3467259?pdf=render |
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