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VOLUME 63 , ISSUE 1 ( January-March, 2021 ) > List of Articles

Original Article

Evaluation of Effect of Category I Anti-Tuberculosis Therapy on Vitamin D Status of Pulmonary Tuberculosis Patients: A Single Centre, Prospective, Observational Study

K.B. Gupta, Abhishek Tandon, Veena Ghalaut, Vipul Kumar, Yash Alok

Keywords : Vitamin D, Tuberculosis, Smoking

Citation Information : Gupta K, Tandon A, Ghalaut V, Kumar V, Alok Y. Evaluation of Effect of Category I Anti-Tuberculosis Therapy on Vitamin D Status of Pulmonary Tuberculosis Patients: A Single Centre, Prospective, Observational Study. Indian J Chest Dis Allied Sci 2021; 63 (1):13-16.

DOI: 10.5005/ijcdas-63-1-13

License: NA

Published Online: 18-03-2021

Copyright Statement:  NA


Abstract

Objective: Tuberculosis (TB) is a significant cause of mortality and morbidity worldwide. Vitamin D deficiency has been implicated to cause pulmonary TB (PTB). On the other hand, anti-TB drugs, like rifampicin and isoniazid have been hypothesised to cause vitamin D deficiency. The objective of this study was to evaluate and compare serum vitamin D status in patients with PTB before and after anti-tuberculosis therapy (ATT). Methods: A single centre, prospective, observational, double-blinded study was conducted in 50 patients with PTB on category I ATT. Vitamin D samples were collected at baseline, two months and at the end of six months. Results: The mean age of the study population was 46.7±21.2 years. The mean serum vitamin D level at baseline was 18.1±6.7 ng/mL (Normal > 30ng/mL), 17.9±7.1 ng/mL at two months and, 17.5±7.8 ng/mL at six months. The progressive decline in the mean vitamin D levels was statistically significant (P<0.001). However, it was also observed that in some patients [n=8 (16%)] vitamin D levels increased after ATT; though in majority [n=42 (84%)] vitamin D levels decreased after ATT. Conclusion: It is postulated that vitamin D supplementation in TB treatment programmes may also have an effect on outcome, thereby the need for further studies to ascertain the exact role, dose and duration of vitamin D augmentation in improving the outcomes.


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  1. Global Tuberculosis Report 2018. World Health Organization, Geneva; 2018. Available at URL: https://www.who.int/tb/publications/global_report/en/. Accessed on January 20, 2019.
  2. Harinarayan CV, Ramalakshmi T, Prasad UV, Sudhakar D, Srinivasarao PV, Sarma KV, et al. High prevalence of low dietary calcium, high phytate consumption, and vitamin D deficiency in healthy South Indians. Am J Clin Nutr 2007;85:1062–7.
  3. Kearns MD, Tangpricha V. The role of vitamin D in tuberculosis. J Clin Transl Endocrinol 2014;1:167–9.
  4. Sutaria N, Liu CT, Chen TC. Vitamin D status, receptor gene polymorphisms, and supplementation on tuberculosis: a systematic review of case-control studies and randomized controlled trials. J Clin Transl Endocrinol 2014;1:151–60.
  5. Wang Z, Lin YS, Zheng XE, Senn T, Hashizume T, Scian M, et al. An inducible cytochrome P4503A4-dependent vitamin D catabolic pathway. Mol Pharmacol 2012;81:498–509.
  6. Raviglione MC, O'Brein RJ. Tuberculosis. In: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson JL, Loscalzo J, editors Principles of Internal Medicine by Harrison's; 18th edition. New York: Mcgraw-Hill; 2011: pp 1340–57.
  7. Hollis BW, Kamerud JQ, Kurkowski A, Beaulieu J, Napoli JL. Quantification of circulating 1, 25-dihydroxy vitamin D by radioimmunoassay with I125-labelled tracer. Clin Chem 1996;42:586–92.
  8. The management of nutrition in major emergencies 2000. World Health Organization, Geneva; 2000. Available at URL: http://whqlibdoc.who.int/publications/2000/9241545208. pdf. Accessed on January 28, 2019.
  9. Lee SW, Kang YA, Yoon YS, Um SW, Lee SM, Yoo CG, et al. The prevalence and evolution of anemia associated with tuberculosis. J Korean Med Sci 2006;21:1028–32.
  10. Afzal A, Rathore R, Butt NF, Randhawa FA. Efficacy of vitamin D supplementation in achieving an early sputum conversion in smear positive pulmonary tuberculosis. Pak J Med Sci 2018;34:849-54.
  11. Hella J, Cercamondi CI, Mhimbira F, Sasamalo M, Stoffel N, Zwahlen M, et al. Anaemia in tuberculosis cases and household controls from Tanzania: contribution of disease, coinfections, and the role of hepcidin. PLoS One 2019;13:e0195985.
  12. Rajpal SK, Amit RN, Aliabbas AH, Seema DS, Ashish RS, Ruchika KJ, et al. Impact of socioeconomic status and living condition on latent tuberculosis diagnosis among the tribal population of Melghat: a cohort study. Lung India 2016;33:372–80.
  13. Naik AL, Rajan MG, Manjrekar PA, Shenoy MT, Shreelata S, Srikantiah RM, et al. Effect of DOTS treatment on vitamin D levels in pulmonary tuberculosis. J Clin Diagn Res 2017;11:BC18–BC22.
  14. Goswami R, Mishra SK, Kochupillai N. Prevalence and potential significance of vitamin D deficiency in Asian Indians. Indian J Med Res 2008;127:229–38.
  15. Ralph AP, Lucas RM, Norval M. Vitamin D and solar ultraviolet radiation in the risk and treatment of tuberculosis. Lancet Infect Dis 2013;13:77–88.
  16. Talat N, Perry S, Parsonnet J, Dawood G, Hussain R. Vitamin D deficiency and tuberculosis progression. Emerg Infect Dis 2010;16:853–5.
  17. Ralph AP, Kelly PM, Anstey NM. L-arginine and vitamin D: novel adjunctive immunotherapies in tuberculosis. Trends Microbiol 2008;16:336–44.
  18. Tostmann A, Wielders JP, Kibiki GS, Verhoef H, Boeree MJ, van der Ven AJ. Serum 25-hydroxy-vitamin D3 concentrations increase during tuberculosis treatment in Tanzania. Int J Tuberc Lung Dis 2010;14:1147–52.
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