Authors: Semba, R.D.¹; Kumwenda, J.²; Zijlstra, E.²; Ricks, M.O.¹; van Lettow, M.¹; Whalen, C.³; Clark, T.D.¹; Jorgensen, L.¹; Kohler, J.¹; Kumwenda, N.²; Taha, T.E.¹; Harries, A.D.⁴

Source: The International Journal of Tuberculosis and Lung Disease, Volume 11, Number 8, August 2007 , pp. 854-859(6)

Publisher: International Union Against Tuberculosis and Lung Disease

Abstract:

SETTING: Zomba and Blantyre, Malawi, Africa.

OBJECTIVES: To determine whether daily micronutrient supplementation reduces the mortality of human immunodeficiency virus (HIV) infected adults with pulmonary tuberculosis (TB).

DESIGN: A randomised, controlled clinical trial of micronutrient supplementation for HIV-positive and HIV-negative adults with pulmonary TB. Participants were enrolled at the commencement of chemotherapy for sputum smear-positive pulmonary TB and followed up for 24 months.

RESULTS: A total of 829 HIV-positive and 573 HIV-negative adults were enrolled. During follow-up, 328 HIV-positive and 17 HIV-negative participants died. The proportion of HIV-positive participants who died in the micronutrient and placebo groups was 38.7% and 40.4%, respectively (P = 0.49). Micronutrient supplementation did not reduce mortality (hazard ratio [HR] 0.93, 95%CI 0.75-1.15) among HIV-positive adults.

CONCLUSIONS: Micronutrient supplementation at the doses used in this study does not reduce mortality in HIV-positive adults with pulmonary TB in Malawi.

Keywords: Africa; HIV; malnutrition; micronutrient; mortality; TB

Document Type: Regular paper

Affiliations: 1: Johns Hopkins Medical Institutions, Baltimore, Maryland, USA 2: Department of Medicine, College of Medicine, University of Malawi, Blantyre, Malawi 3: Department of Epidemiology and Biostatistics and Tuberculosis Research Unit, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA 4: HIV Unit, Ministry of Health, Malawi, and National TB Control Programme, Lilongwe, Malawi

Publication date: 2007-08-01

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