{"doi":"10.1371/journal.pone.0318819","title":"Resistance to tuberculin skin test/interferon-gamma release assay conversion among highly TB exposed, HIV infected goldminers in South Africa","abstract":"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/m2. 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 TST/IGRA conversion resistance are not well understood.","journal":"PLoS ONE","year":2025,"id":552711,"datarank":0.10397207708399181,"base_score":0.6931471805599453,"endowment":0.6931471805599453,"self_citation_contribution":0.10397207708399181,"citation_network_contribution":0.0,"self_endowment_contribution":0.10397207708399181,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9584,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":694281,"name":"Kavindhran Velen","orcid":"0000-0001-8577-3915","position":1,"is_corresponding":false},{"id":1449497,"name":"Sibuse Ginindza","orcid":null,"position":2,"is_corresponding":false},{"id":1449498,"name":"Lindiwe Nhlangulela","orcid":null,"position":3,"is_corresponding":false},{"id":516266,"name":"Salome Charalambous","orcid":"0000-0001-7143-1009","position":4,"is_corresponding":false},{"id":445178,"name":"Thomas R. Hawn","orcid":"0000-0003-2368-3185","position":5,"is_corresponding":false},{"id":432140,"name":"Gavin Churchyard","orcid":"0000-0002-4269-3699","position":6,"is_corresponding":false},{"id":231891,"name":"W. Henry Boom","orcid":"0000-0001-5760-9595","position":7,"is_corresponding":false},{"id":694278,"name":"Violet Chihota","orcid":"0000-0003-1444-9266","position":8,"is_corresponding":false},{"id":573481,"name":"Robert S. Wallis","orcid":"0000-0001-6152-5183","position":9,"is_corresponding":false},{"id":694279,"name":"Thobani Ntshiqa","orcid":"0000-0002-0752-3192","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:54:37.527189Z","pmid":"40343976","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}