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Adjunctive micronutrient supplementation for pulmonary tuberculosis

Abstract:

Objective: To assess the effect of micronutrient supplementation on tuberculosis (TB) patient outcomes. Material and Methods: The randomized, double-blinded, placebo-controlled study was conducted in pulmonary TB patients undergoing directly observed treatment short course/tratamiento acortado estrictamente supervisado (TAES/DOTS) at IMSS in Ciudad Juarez, Chihuahua, Mexico, who were recruited during August 2005-July 2006. Consecutive patients received zinc and vitamin A supplements or matched placebo for four months. Dietary intake, blood zinc and vitamin A, immune response (IFN-γ, TNF-α, and IL-10 mRNA), and sputum smear conversion were measured. Results: The proportion of micronutrient compared to placebo group subjects with a negative sputum smear by month 3 was significantly increased (p= 0.03). This occurred subsequent to increased TNF-α and IFN-γ and decreased IL-10 observed at month 2. Micronutrient supplementation appeared to accelerate the beneficial therapeutic effect of chemotherapy. Conclusions: The earlier elimination of bacilli from sputum was associated with improved zinc status and Th1 immune response. The therapeutic effect of vitamin A was less evident.