| April
27, 2008
Common Vitamin And Other Micronutrient Supplements Reduce Risks Of TB Recurrence, Study Suggests
ScienceDaily (Apr. 27, 2008) — New findings show a link between micronutrient supplementation and reduced risk of recurrence during tuberculosis chemotherapy, according to a new study.
Nutritional assessment and support in tuberculosis therapy, once common before the advent of anti-TB drugs, is no longer an integral part of clinical therapy in most low-income countries even though poor nutrition impairs the immune system and leads to risk of further infection and relapse.
In Tanzania, Eduardo Villamor, MD, DrPH, of the Harvard School of Public Health, and a team of researchers conducted a randomized trial of micronutrients using doses of vitamins A, B-complex, C, E, and selenium or placebo in 887 patients receiving tuberculosis therapy, who were then followed for a medium of 43 months; 471 were HIV-coinfected and not receiving antiretroviral therapy and 416 were HIV-uninfected.
The study showed that micronutrient supplementation was associated with reduced rates of TB recurrence. In the study, both HIV-infected and uninfected patients with pulmonary TB who were receiving the supplements had a decreased risk of TB recurrence during the next few months after the TB culture had become negative: 45 percent overall and 63 percent in HIV-infected patients. Supplementation also reduced the incidence of peripheral neuropathy by 57 percent, irrespective of HIV status, and increased the levels of certain cells (CD3 and CD4) important in immune response in HIV-uninfected patients.
As Villamor noted, "We found that providing micronutrients to patients with tuberculosis who were undergoing anti-TB treatment appeared to decrease the risk of recurrences. This effect was stronger in patients infected with HIV than in those who were HIV-negative. This could be relevant because TB reactivation is common among HIV-infected persons." Villamor further noted, "that it will be important to find out whether micronutrients improve the outcome of TB treatment in TB-HIV co-infected patients who are undergoing antiretroviral therapy."
Christine Stabell Benn, MD, and colleagues in Copenhagen noted in their accompanying editorial that results to date relating to TB recurrence and mortality are inconsistent, with previous studies using different dosages and combinations of micronutrients. Dr. Stabell pointed out that the promising results of the Villamor study show that further investigations are needed to develop optimal combinations of micronutrients that can be provided inexpensively in TB therapy to reduce relapses and increase survival.
The effects of micronutrient supplementation in TB-HIV co-infected patients undergoing antiretroviral therapy have yet to be studied.
The article, Supplements of common vitamins and other micronutrients may reduce the risk of recurrence in patients receiving tuberculosis treatment, was published in the June 1, 2008 issue of The Journal of Infectious Diseases, available early online.
Source: www.sciencedaily.com
Comments:
Although malnourishment is very common in developing countries where tuberculosis is most prevalent, nutritional assessment and proper support has long stopped being the part of their recovery program. An anti tubercular drug regimen has become the mainstay of treatment without addressing nutritional status. With the growing population of immuno-compromised patients due to HIV/AIDS, tuberculosis and its drug resistant version is emerging as a public health threat in developed countries as well. According to the World Health Organization (WHO), one-third of the global population is currently infected with the tuberculosis bacillus. Yet the importance of appropriate nutritional support is not considered essential. This study by Harvard University emphasizes such importance and proves that the micronutrient supplements could be an inexpensive and effective way of reducing the risks of recurrence of infection, in spite of the HIV status. In this randomized study it is proven that with the daily supplementation of micronutrient vitamins A, B-complex, C, E, and selenium, the risk of TB recurrence was reduced by 45% in the study subjects receiving the supplements, and by 63% in HIV infected subjects. Additionally, in HIV-negative subjects, an increase in levels of CD3+ and CD4+ T- cells indicated a definite positive effect on the immune system. Despite such clear evidence of efficacy, the editorial of Journal of Infectious Diseases stated, “Some micronutrients may have conflicting evidence with respect to effect and interaction with other micronutrients and should, therefore, be tested individually for inclusion in the minimal package of micronutrients."
Studies conducted by Dr. Rath's Health Foundation in tuberculosis have already proven the benefits of micronutrient supplementation but Dr. Rath's research in other chronic diseases including cardiovascular disease and cancer emphasizes the importance of nutrient synergy. Individual nutrients are not as effective as the combination of specific nutrients in specific proportion–like the ones used in Dr. Rath's studies and also in this study– is more effective. This study confirms that the findings observed in Dr. Rath's studies are correct. You can read more about nutrient synergy on www.cellularhealthtraining.org and about Dr. Rath's research on www.drrathresearch.org and www4.dr-rath-foundation.org
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