Universidad Peruana Cayetano Heredia

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

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dc.contributor.author Schwalb Calderon, Alvaro
dc.contributor.author Bergstrom, Malin
dc.contributor.author Woodd, Susannah
dc.contributor.author Rehman, Andrea M.
dc.contributor.author PrayGod, George
dc.contributor.author Kasonka, Lackson
dc.contributor.author Koethe, John R.
dc.contributor.author Filteau, Suzanne
dc.contributor.author Houben, Rein M. G. J.
dc.coverage.spatial Mwanza, Tanzania
dc.coverage.spatial Lusaka, Zambia
dc.date.accessioned 2023-09-06T20:45:09Z
dc.date.available 2023-09-06T20:45:09Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/14076
dc.description.abstract 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/m2) 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/m2 = 1.15 [0.82-1.62] and <16kg/m2 = 1.70 [1.26-2.30] compared to 17-18.5kg/m2; 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. en_US
dc.language.iso eng
dc.publisher PLoS
dc.relation.ispartofseries PLOS Global Public Health
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Tuberculosis en_US
dc.subject Epidemiology en_US
dc.subject Nutrition en_US
dc.subject Vitamins en_US
dc.subject HIV en_US
dc.subject C-reactive proteins en_US
dc.subject Lipids en_US
dc.subject HIV epidemiology en_US
dc.subject.mesh Tuberculosis
dc.subject.mesh Epidemiología
dc.subject.mesh Ciencias de la Nutrición
dc.subject.mesh Vitaminas
dc.subject.mesh VIH
dc.subject.mesh Proteína C-Reactiva
dc.subject.mesh Lípidos
dc.subject.mesh Epidemiología
dc.title Impact of micro- and macronutrient status on the incidence of tuberculosis: An examination of an African cohort initiating antiretroviral therapy. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pgph.0002007
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.03.08
dc.relation.issn 2767-3375


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