BACKGROUND: Low serum concentrations of vitamin A and zinc are common in tuberculosis and may have an adverse effect on host cell-mediated responses. The role of adjunctive micronutrient supplementation on treatment outcomes is uncertain. OBJECTIVE: The objective was to assess the efficacy of vitamin A and zinc supplementation on sputum smear and culture conversion and time to culture detection in adults with sputum smear-positive pulmonary tuberculosis. DESIGN:Participants attending a primary care tuberculosis clinic in Cape Town, South Africa, were randomly assigned to receive micronutrients (single dose of 200,000 IU retinyl palmitate plus 15 mg Zn/d for 8 wk) or matching placebo. Sputum was collected weekly for 8 wk for auramine staining and culture on liquid media (BACTEC MGIT 960; Becton Dickinson, Sparks, MD). Performance status, chest radiographs, and anthropometric measures were assessed at baseline and again at 8 wk. RESULTS: The participants (n = 154) were randomly assigned to the micronutrient (n = 77) or placebo (n = 77) group. Twenty participants were HIV infected (13%), and 12 participants had an unknown HIV status (8%). No differences in time to smear or culture conversion were observed between the treatment groups by Kaplan-Meier analysis (P = 0.15 and P = 0.38, respectively; log-rank test). Log-logistic regression analysis found no significant group interaction effect in time to culture detection over the 8-wk period (P = 0.32). No significant differences in weight gain (2.3 ± 3.5 compared with 2.2 ± 2.4 kg, P = 0.68) or radiologic resolution were observed between the treatment groups. CONCLUSION: Supplementation with vitamin A and zinc did not affect treatment outcomes in participants with pulmonary tuberculosis at 8 wk. This trial was registered at controlled-trials.com as ISRCTN80852505.
RCT Entities:
BACKGROUND: Low serum concentrations of vitamin A and zinc are common in tuberculosis and may have an adverse effect on host cell-mediated responses. The role of adjunctive micronutrient supplementation on treatment outcomes is uncertain. OBJECTIVE: The objective was to assess the efficacy of vitamin A and zinc supplementation on sputum smear and culture conversion and time to culture detection in adults with sputum smear-positive pulmonary tuberculosis. DESIGN:Participants attending a primary care tuberculosis clinic in Cape Town, South Africa, were randomly assigned to receive micronutrients (single dose of 200,000 IU retinyl palmitate plus 15 mg Zn/d for 8 wk) or matching placebo. Sputum was collected weekly for 8 wk for auramine staining and culture on liquid media (BACTEC MGIT 960; Becton Dickinson, Sparks, MD). Performance status, chest radiographs, and anthropometric measures were assessed at baseline and again at 8 wk. RESULTS: The participants (n = 154) were randomly assigned to the micronutrient (n = 77) or placebo (n = 77) group. Twenty participants were HIV infected (13%), and 12 participants had an unknown HIV status (8%). No differences in time to smear or culture conversion were observed between the treatment groups by Kaplan-Meier analysis (P = 0.15 and P = 0.38, respectively; log-rank test). Log-logistic regression analysis found no significant group interaction effect in time to culture detection over the 8-wk period (P = 0.32). No significant differences in weight gain (2.3 ± 3.5 compared with 2.2 ± 2.4 kg, P = 0.68) or radiologic resolution were observed between the treatment groups. CONCLUSION: Supplementation with vitamin A and zinc did not affect treatment outcomes in participants with pulmonary tuberculosis at 8 wk. This trial was registered at controlled-trials.com as ISRCTN80852505.
Authors: Matthew Wheelwright; Elliot W Kim; Megan S Inkeles; Avelino De Leon; Matteo Pellegrini; Stephan R Krutzik; Philip T Liu Journal: J Immunol Date: 2014-02-05 Impact factor: 5.422
Authors: Emmanuel Chigutsa; Jotam G Pasipanodya; Marianne E Visser; Paul D van Helden; Peter J Smith; Frederick A Sirgel; Tawanda Gumbo; Helen McIlleron Journal: Antimicrob Agents Chemother Date: 2014-10-13 Impact factor: 5.191
Authors: Emmanuel Chigutsa; Marianne E Visser; Elizabeth C Swart; Paolo Denti; Sudeep Pushpakom; Deirdre Egan; Nicholas H G Holford; Peter J Smith; Gary Maartens; Andrew Owen; Helen McIlleron Journal: Antimicrob Agents Chemother Date: 2011-06-27 Impact factor: 5.191
Authors: Jotam G Pasipanodya; Helen McIlleron; André Burger; Peter A Wash; Peter Smith; Tawanda Gumbo Journal: J Infect Dis Date: 2013-07-29 Impact factor: 5.226
Authors: Emmanuel Chigutsa; Kashyap Patel; Paolo Denti; Marianne Visser; Gary Maartens; Carl M J Kirkpatrick; Helen McIlleron; Mats O Karlsson Journal: Antimicrob Agents Chemother Date: 2012-11-26 Impact factor: 5.191