A Trial of the Effect of Micronutrient Supplementation on Treatment Outcome, T Cell Counts, Morbidity, and Mortality in Adults with Pulmonary Tuberculosis

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A Trial of the Effect of Micronutrient Supplementation on Treatment Outcome, T Cell Counts, Morbidity, and Mortality in Adults with Pulmonary Tuberculosis

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Title: A Trial of the Effect of Micronutrient Supplementation on Treatment Outcome, T Cell Counts, Morbidity, and Mortality in Adults with Pulmonary Tuberculosis
Author: Villamor, Eduardo; Mugusi, Ferdinand; Urassa, Willy; Bosch, Ronald J.; Saathoff, Elmar; Matsumoto, Kenji; Meydani, Simin N.; Fawzi, Wafaie W.

Note: Order does not necessarily reflect citation order of authors.

Citation: Villamor, Eduardo, Ferdinand Mugusi, Willy Urassa, Ronald J. Bosch, Elmar Saathoff, Kenji Matsumoto, Simin N. Meydani, and Wafaie W. Fawzi. 2008. “A Trial of the Effect of Micronutrient Supplementation on Treatment Outcome, T Cell Counts, Morbidity, and Mortality in Adults with Pulmonary Tuberculosis.” J. Infect. Dis. 197 (11) (June): 1499–1505. doi:10.1086/587846.
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Abstract: Background

Tuberculosis (TB) often coincides with nutritional deficiencies. The effects of micronutrient supplementation on TB treatment outcomes, clinical complications, and mortality are uncertain.

Methods

We conducted a randomized, double-blind, placebo-controlled trial of micronutrients (vitamins A, B complex, C, and E, as well as selenium) in Dar es Salaam, Tanzania. We enrolled 471 human immunodeficiency virus (HIV)–infected and 416 HIV-negative adults with pulmonary TB at the time of initiating chemotherapy and monitored them for a median of 43 months.

Results

Micronutrients decreased the risk of TB recurrence by 45% overall (95% confidence interval [CI], 7% to 67%; P = .02) and by 63% in HIV-infected patients (95% CI, 8% to 85%; P = .02). There were no significant effects on mortality overall; however, we noted a marginally significant 64% reduction of deaths in HIV-negative subjects (95% CI, −14% to 88%; P = .08). Supplementation increased CD3+ and CD4+ cell counts and decreased the incidence of extrapulmonary TB and genital ulcers in HIV-negative patients. Micronutrients reduced the incidence of peripheral neuropathy by 57% (95% CI, 41% to 69%; P < .001), irrespective of HIV status. There were no significant effects on weight gain, body composition, anemia, or HIV load.

Conclusions

Micronutrient supplementation could improve the outcome in patients undergoing TB chemotherapy in Tanzania.
Published Version: doi:10.1086/587846
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564793/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:26966951
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