Cargando…

Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes

SETTING: Vitamin D deficiency is common in African adults with tuberculosis (TB), and may be exacerbated by the metabolic effects of anti-tuberculosis drugs and antiretroviral therapy (ART). It is unclear whether vitamin D deficiency influences response to anti-tuberculosis treatment. OBJECTIVES: To...

Descripción completa

Detalles Bibliográficos
Autores principales: Sloan, D. J., Mwandumba, H. C., Kamdolozi, M., Shani, D., Chisale, B., Dutton, J., Khoo, S. H., Allain, T. J., Davies, G. R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Union Against Tuberculosis and Lung Disease 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497634/
https://www.ncbi.nlm.nih.gov/pubmed/26162355
http://dx.doi.org/10.5588/ijtld.15.0071
_version_ 1782380532974223360
author Sloan, D. J.
Mwandumba, H. C.
Kamdolozi, M.
Shani, D.
Chisale, B.
Dutton, J.
Khoo, S. H.
Allain, T. J.
Davies, G. R.
author_facet Sloan, D. J.
Mwandumba, H. C.
Kamdolozi, M.
Shani, D.
Chisale, B.
Dutton, J.
Khoo, S. H.
Allain, T. J.
Davies, G. R.
author_sort Sloan, D. J.
collection PubMed
description SETTING: Vitamin D deficiency is common in African adults with tuberculosis (TB), and may be exacerbated by the metabolic effects of anti-tuberculosis drugs and antiretroviral therapy (ART). It is unclear whether vitamin D deficiency influences response to anti-tuberculosis treatment. OBJECTIVES: To describe risk factors for baseline vitamin D deficiency in Malawian adults with pulmonary TB, assess the relationship between serum 25-hydroxy vitamin D (25[OH]D) concentration and treatment response, and evaluate whether the administration of anti-tuberculosis drugs and ART is deleterious to vitamin D status during treatment. DESIGN: A prospective longitudinal cohort study. RESULTS: The median baseline 25(OH)D concentration of the 169 patients (58% human immunodeficiency virus [HIV] infected) recruited was 57 nmol/l; 47 (28%) had vitamin D deficiency (<50 nmol/l). Baseline 25(OH)D concentrations were lower during the cold season (P < 0.001), with food insecurity (P = 0.034) or in patients who consumed alcohol (P = 0.019). No relationship between vitamin D status and anti-tuberculosis treatment response was found. 25(OH)D concentrations increased during anti-tuberculosis treatment, irrespective of HIV status or use of ART. CONCLUSIONS: Vitamin D deficiency is common among TB patients in Malawi, but this does not influence treatment response. Adverse metabolic effects of drug treatment may be compensated by the positive impact of clinical recovery preventing exacerbation of vitamin D deficiency during anti-tuberculosis treatment.
format Online
Article
Text
id pubmed-4497634
institution National Center for Biotechnology Information
language English
publishDate 2015
publisher International Union Against Tuberculosis and Lung Disease
record_format MEDLINE/PubMed
spelling pubmed-44976342015-08-01 Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes Sloan, D. J. Mwandumba, H. C. Kamdolozi, M. Shani, D. Chisale, B. Dutton, J. Khoo, S. H. Allain, T. J. Davies, G. R. Int J Tuberc Lung Dis Original Articles SETTING: Vitamin D deficiency is common in African adults with tuberculosis (TB), and may be exacerbated by the metabolic effects of anti-tuberculosis drugs and antiretroviral therapy (ART). It is unclear whether vitamin D deficiency influences response to anti-tuberculosis treatment. OBJECTIVES: To describe risk factors for baseline vitamin D deficiency in Malawian adults with pulmonary TB, assess the relationship between serum 25-hydroxy vitamin D (25[OH]D) concentration and treatment response, and evaluate whether the administration of anti-tuberculosis drugs and ART is deleterious to vitamin D status during treatment. DESIGN: A prospective longitudinal cohort study. RESULTS: The median baseline 25(OH)D concentration of the 169 patients (58% human immunodeficiency virus [HIV] infected) recruited was 57 nmol/l; 47 (28%) had vitamin D deficiency (<50 nmol/l). Baseline 25(OH)D concentrations were lower during the cold season (P < 0.001), with food insecurity (P = 0.034) or in patients who consumed alcohol (P = 0.019). No relationship between vitamin D status and anti-tuberculosis treatment response was found. 25(OH)D concentrations increased during anti-tuberculosis treatment, irrespective of HIV status or use of ART. CONCLUSIONS: Vitamin D deficiency is common among TB patients in Malawi, but this does not influence treatment response. Adverse metabolic effects of drug treatment may be compensated by the positive impact of clinical recovery preventing exacerbation of vitamin D deficiency during anti-tuberculosis treatment. International Union Against Tuberculosis and Lung Disease 2015-08 /pmc/articles/PMC4497634/ /pubmed/26162355 http://dx.doi.org/10.5588/ijtld.15.0071 Text en © 2015 Sloan et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (http://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 Original Articles
Sloan, D. J.
Mwandumba, H. C.
Kamdolozi, M.
Shani, D.
Chisale, B.
Dutton, J.
Khoo, S. H.
Allain, T. J.
Davies, G. R.
Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes
title Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes
title_full Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes
title_fullStr Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes
title_full_unstemmed Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes
title_short Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes
title_sort vitamin d deficiency in malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4497634/
https://www.ncbi.nlm.nih.gov/pubmed/26162355
http://dx.doi.org/10.5588/ijtld.15.0071
work_keys_str_mv AT sloandj vitaminddeficiencyinmalawianadultswithpulmonarytuberculosisriskfactorsandtreatmentoutcomes
AT mwandumbahc vitaminddeficiencyinmalawianadultswithpulmonarytuberculosisriskfactorsandtreatmentoutcomes
AT kamdolozim vitaminddeficiencyinmalawianadultswithpulmonarytuberculosisriskfactorsandtreatmentoutcomes
AT shanid vitaminddeficiencyinmalawianadultswithpulmonarytuberculosisriskfactorsandtreatmentoutcomes
AT chisaleb vitaminddeficiencyinmalawianadultswithpulmonarytuberculosisriskfactorsandtreatmentoutcomes
AT duttonj vitaminddeficiencyinmalawianadultswithpulmonarytuberculosisriskfactorsandtreatmentoutcomes
AT khoosh vitaminddeficiencyinmalawianadultswithpulmonarytuberculosisriskfactorsandtreatmentoutcomes
AT allaintj vitaminddeficiencyinmalawianadultswithpulmonarytuberculosisriskfactorsandtreatmentoutcomes
AT daviesgr vitaminddeficiencyinmalawianadultswithpulmonarytuberculosisriskfactorsandtreatmentoutcomes