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

Derek James Sloan; H. C. Mwandumba; M. Kamdolozi; D. Shani; B. Chisale; J. Dutton; S. H. Khoo; T. J. Allain; G. R. Davies

doi:10.5588/ijtld.15.0071

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

Derek James Sloan^*, H. C. Mwandumba, M. Kamdolozi, D. Shani, B. Chisale, J. Dutton, S. H. Khoo, T. J. Allain, G. R. Davies

^*Corresponding author for this work

School of Medicine

Research output: Contribution to journal › Article › peer-review

Abstract

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 antituberculosis 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.

Original language	English
Pages (from-to)	904-911
Number of pages	8
Journal	International Journal of Tuberculosis and Lung Disease
Volume	19
Issue number	8
DOIs	https://doi.org/10.5588/ijtld.15.0071
Publication status	Published - 1 Aug 2015

Keywords

HIV
Antiretroviral therapy
Relapse
Seasonality
Treatment failure

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Derek James Sloan
- djs26st-andrews.acuk
- School of Medicine - Reader/Consultant in Infectious Diseases
- Infection and Global Health Division
Person: Academic

Cite this

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title = "Vitamin D deficiency in Malawian adults with pulmonary tuberculosis: risk factors and treatment outcomes",

abstract = "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 antituberculosis 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.",

keywords = "HIV, Antiretroviral therapy, Relapse, Seasonality, Treatment failure",

author = "Sloan, {Derek James} and Mwandumba, {H. C.} and M. Kamdolozi and D. Shani and B. Chisale and J. Dutton and Khoo, {S. H.} and Allain, {T. J.} and Davies, {G. R.}",

note = "The study was supported by a Wellcome Trust (London, UK) Clinical PhD Fellowship awarded to DS (086757/Z/08/A) and the Malawi Liverpool Wellcome Trust (MLW) Core grant from the Wellcome Trust.",

year = "2015",

month = aug,

day = "1",

doi = "10.5588/ijtld.15.0071",

language = "English",

volume = "19",

pages = "904--911",

journal = "International Journal of Tuberculosis and Lung Disease",

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T1 - Vitamin D deficiency in Malawian adults with pulmonary tuberculosis

T2 - risk factors and treatment outcomes

AU - Sloan, Derek James

AU - Mwandumba, H. C.

AU - Kamdolozi, M.

AU - Shani, D.

AU - Chisale, B.

AU - Dutton, J.

AU - Khoo, S. H.

AU - Allain, T. J.

AU - Davies, G. R.

N1 - The study was supported by a Wellcome Trust (London, UK) Clinical PhD Fellowship awarded to DS (086757/Z/08/A) and the Malawi Liverpool Wellcome Trust (MLW) Core grant from the Wellcome Trust.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - 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 antituberculosis 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.

AB - 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 antituberculosis 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.

KW - HIV

KW - Antiretroviral therapy

KW - Relapse

KW - Seasonality

KW - Treatment failure

U2 - 10.5588/ijtld.15.0071

DO - 10.5588/ijtld.15.0071

M3 - Article

AN - SCOPUS:84938221168

SN - 1027-3719

VL - 19

SP - 904

EP - 911

JO - International Journal of Tuberculosis and Lung Disease

JF - International Journal of Tuberculosis and Lung Disease

IS - 8

ER -

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

Abstract

Keywords

UN SDGs

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