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Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy

Macronutrient and micronutrient deficiencies are associated with tuberculosis (TB) incidence. However, evidence is limited on the impact of micronutrient (vitamins and minerals) supplementation among underweight individuals. We conducted a secondary data analysis of a randomised controlled trial of...

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Autores principales: Schwalb, Alvaro, Bergstrom, Malin, Woodd, Susannah, Rehman, Andrea M., PrayGod, George, Kasonka, Lackson, Koethe, John R., Filteau, Suzanne, Houben, Rein M. G. J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343057/
https://www.ncbi.nlm.nih.gov/pubmed/37440476
http://dx.doi.org/10.1371/journal.pgph.0002007
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author Schwalb, Alvaro
Bergstrom, Malin
Woodd, Susannah
Rehman, Andrea M.
PrayGod, George
Kasonka, Lackson
Koethe, John R.
Filteau, Suzanne
Houben, Rein M. G. J.
author_facet Schwalb, Alvaro
Bergstrom, Malin
Woodd, Susannah
Rehman, Andrea M.
PrayGod, George
Kasonka, Lackson
Koethe, John R.
Filteau, Suzanne
Houben, Rein M. G. J.
author_sort Schwalb, Alvaro
collection PubMed
description Macronutrient and micronutrient deficiencies are associated with tuberculosis (TB) incidence. However, evidence is limited on the impact of micronutrient (vitamins and minerals) supplementation among underweight individuals. We conducted a secondary data analysis of a randomised controlled trial of lipid nutritional supplements with and without high-dose vitamin and mineral supplementation (LNS-VM vs LNS) for underweight (Body Mass Index [BMI] <18.5 kg/m(2)) adults with human immunodeficiency virus (HIV) initiating antiretroviral therapy (ART) in Tanzania and Zambia (2011–2013). Incident TB disease diagnoses were extracted from trial records. We used multivariable Cox regression to estimate hazard ratios (HR) for the impact of receiving LNS-VM on TB incidence, and the dose-response relationship between baseline BMI and TB incidence. Overall, 263 (17%) of 1506 participants developed TB disease. After adjusting for age, sex, CD4 count, haemoglobin, and C-reactive protein, receiving LNS-VM was not associated with TB incidence (aHR [95%CI] = 0.93 [0.72–1.20]; p = 0.57) compared to LNS alone. There was strong evidence for an association between lower BMI and incident TB (aHR [95%CI]: 16–16.9kg/m(2) = 1.15 [0.82–1.62] and <16kg/m(2) = 1.70 [1.26–2.30] compared to 17–18.5kg/m(2); linear trend p<0.01). There was strong evidence that the rate of developing TB was lower after initiating ART (p<0.01). In conclusion, the addition of micronutrient supplementation to LNS was not associated with lower TB incidence in this underweight ART-naive population.
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spelling pubmed-103430572023-07-14 Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy Schwalb, Alvaro Bergstrom, Malin Woodd, Susannah Rehman, Andrea M. PrayGod, George Kasonka, Lackson Koethe, John R. Filteau, Suzanne Houben, Rein M. G. J. PLOS Glob Public Health Research Article Macronutrient and micronutrient deficiencies are associated with tuberculosis (TB) incidence. However, evidence is limited on the impact of micronutrient (vitamins and minerals) supplementation among underweight individuals. We conducted a secondary data analysis of a randomised controlled trial of lipid nutritional supplements with and without high-dose vitamin and mineral supplementation (LNS-VM vs LNS) for underweight (Body Mass Index [BMI] <18.5 kg/m(2)) adults with human immunodeficiency virus (HIV) initiating antiretroviral therapy (ART) in Tanzania and Zambia (2011–2013). Incident TB disease diagnoses were extracted from trial records. We used multivariable Cox regression to estimate hazard ratios (HR) for the impact of receiving LNS-VM on TB incidence, and the dose-response relationship between baseline BMI and TB incidence. Overall, 263 (17%) of 1506 participants developed TB disease. After adjusting for age, sex, CD4 count, haemoglobin, and C-reactive protein, receiving LNS-VM was not associated with TB incidence (aHR [95%CI] = 0.93 [0.72–1.20]; p = 0.57) compared to LNS alone. There was strong evidence for an association between lower BMI and incident TB (aHR [95%CI]: 16–16.9kg/m(2) = 1.15 [0.82–1.62] and <16kg/m(2) = 1.70 [1.26–2.30] compared to 17–18.5kg/m(2); linear trend p<0.01). There was strong evidence that the rate of developing TB was lower after initiating ART (p<0.01). In conclusion, the addition of micronutrient supplementation to LNS was not associated with lower TB incidence in this underweight ART-naive population. Public Library of Science 2023-07-13 /pmc/articles/PMC10343057/ /pubmed/37440476 http://dx.doi.org/10.1371/journal.pgph.0002007 Text en © 2023 Schwalb et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Schwalb, Alvaro
Bergstrom, Malin
Woodd, Susannah
Rehman, Andrea M.
PrayGod, George
Kasonka, Lackson
Koethe, John R.
Filteau, Suzanne
Houben, Rein M. G. J.
Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy
title Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy
title_full Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy
title_fullStr Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy
title_full_unstemmed Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy
title_short Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy
title_sort impact of micro- and macronutrient status on the incidence of tuberculosis: an examination of an african cohort initiating antiretroviral therapy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10343057/
https://www.ncbi.nlm.nih.gov/pubmed/37440476
http://dx.doi.org/10.1371/journal.pgph.0002007
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