Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa

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dc.contributor.authorOni, Toluen_ZA
dc.contributor.authorGideon, Hannah Pen_ZA
dc.contributor.authorBangani, Nonzwakazien_ZA
dc.contributor.authorTsekela, Relebohileen_ZA
dc.contributor.authorSeldon, Ronnetten_ZA
dc.contributor.authorWood, Kathrynen_ZA
dc.contributor.authorWilkinson, Katalin Aen_ZA
dc.contributor.authorGoliath, Rene Ten_ZA
dc.contributor.authorOttenhoff, Tom H Men_ZA
dc.contributor.authorWilkinson, Robert Jen_ZA
dc.date.accessioned2015-12-28T06:47:43Z
dc.date.available2015-12-28T06:47:43Z
dc.date.issued2012en_ZA
dc.description.abstractBACKGROUND: 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.en_ZA
dc.identifier.apacitationOni, T., Gideon, H. P., Bangani, N., Tsekela, R., Seldon, R., Wood, K., ... Wilkinson, R. J. (2012). Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa. <i>PLoS One</i>, http://hdl.handle.net/11427/16044en_ZA
dc.identifier.chicagocitationOni, Tolu, Hannah P Gideon, Nonzwakazi Bangani, Relebohile Tsekela, Ronnett Seldon, Kathryn Wood, Katalin A Wilkinson, Rene T Goliath, Tom H M Ottenhoff, and Robert J Wilkinson "Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa." <i>PLoS One</i> (2012) http://hdl.handle.net/11427/16044en_ZA
dc.identifier.citationOni, T., Gideon, H. P., Bangani, N., Tsekela, R., Seldon, R., Wood, K., ... & Wilkinson, R. J. (2011). Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa. PloS one, 7(10), e47072-e47072. doi:10.1371/journal.pone.0047072en_ZA
dc.identifier.ris TY - Journal Article AU - Oni, Tolu AU - Gideon, Hannah P AU - Bangani, Nonzwakazi AU - Tsekela, Relebohile AU - Seldon, Ronnett AU - Wood, Kathryn AU - Wilkinson, Katalin A AU - Goliath, Rene T AU - Ottenhoff, Tom H M AU - Wilkinson, Robert J AB - 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. DA - 2012 DB - OpenUCT DO - 10.1371/journal.pone.0047072 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2012 T1 - Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa TI - Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa UR - http://hdl.handle.net/11427/16044 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16044
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0047072
dc.identifier.vancouvercitationOni T, Gideon HP, Bangani N, Tsekela R, Seldon R, Wood K, et al. Smoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africa. PLoS One. 2012; http://hdl.handle.net/11427/16044.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentInstitute of Infectious Disease and Molecular Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© Oni et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherTuberculosisen_ZA
dc.subject.otherTuberculinen_ZA
dc.subject.otherHIVen_ZA
dc.subject.otherVaccination and immunizationen_ZA
dc.subject.otherAdultsen_ZA
dc.subject.otherChildrenen_ZA
dc.subject.otherSkin testsen_ZA
dc.subject.otherHIV epidemiologyen_ZA
dc.titleSmoking, BCG and employment and the risk of tuberculosis infection in HIV-infected persons in South Africaen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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