Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.
Resistance to Mycobacterium tuberculosis infection among highly TB exposed South African gold miners.
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DOI：
10.1371/journal.pone.0265036
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发表时间：
2022
期刊：
影响因子：
3.7
通讯作者：
Fielding K
中科院分区：
文献类型：
--
作者：
Chihota VN;Ntshiqa T;Maenetje P;Mansukhani R;Velen K;Hawn TR;Wallis R;Grant AD;Churchyard GJ;Fielding K
尽管大量接触结核分枝杆菌，但一小部分南非金矿工人仍能抵抗结核病感染。在长期工作的金矿工人中，我们确定了1)未感染结核病的比例和2)与未感染相关的流行病学因素。我们招募了年龄33-60岁的艾滋病病毒阴性的黄金矿工，他们在≥工作了15年，没有结核病或矽肺病史。矿工被定义为未感染结核病，如果i)Quantiferon-TB Gold Plus(QFT-Plus)阴性或ii)在更严格的定义中，QFT-Plus-阴性和TST零反应，以及如果他们是黑人/非洲族裔，并且在两种测试中都是阴性的，则被定义为抵抗者。Logistic回归用于确定与未感染结核病相关的流行病学因素。在307名有QFT-Plus结果的参与者中，中位年龄为48岁(四分位数范围[IQR]44-53)，在地下工作的中位时间为24年(IQR 18-28)，303名(99%)为男性，91名(30%)QFT-Plus阴性。非技术工人未感染结核病的几率降低了52%(调整后的优势比[AOR]为0.48；95%可信区间[CI]为0.27-0.85；p=0.013)。在281名黑人/非洲族裔的参与者中，71人(25%)是QFT-Plus阴性。体重指数≥为30的矿工患未感染结核病的可能性较低(OR0.38；95%CI0.18-0.80)。使用更严格的定义，44.3%(136/307)的矿工被归类为未感染的结核病(35；26%)或已感染的(101；74%)，两者之间的关联仍然相似。在黑人/非洲矿工中，使用更严格的定义，123人被归类为未感染结核病(23；19%)或已感染结核病(100；81%)。没有确定未感染结核病的流行病学因素。尽管累积暴露量很高，但一小部分矿工似乎对结核病感染具有抵抗力，而且没有明显的流行病学特征。
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.
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