Adriana Campa, Marianna K Baum, Hermann Bussmann, Sabrina Sales Martinez, Mansour Farahani, Erik van Widenfelt, Sikhulile Moyo, Joseph Makhema, Max Essex, Richard Marlink
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Those participants with prior or current active TB were excluded, as were participants with advanced HIV disease (CD4 <250 cells/μL) or who had already qualified for ART. HIV-positive adults (N=878) were followed monthly for study pill dispensation, every 3 months for CD4 cell count and every 6 months for viral load during 24 months or until they were started on ART.</p><p><strong>Results: </strong>The participants' characteristics were not significantly different among the four groups at baseline. Supplementation with Se alone (hazard ratio =0.20, 95% confidence interval: 0.04, 0.95, <i>P</i>=0.043) and the two combined SE groups (Se and Se+MVT) had significantly lower risk of developing incident TB disease compared with placebo in multivariate adjusted models (hazard ratio=0.32, 95% confidence interval: 0.11, 0.93, <i>P</i>=0.036). Multivitamins alone did not affect the incidence of TB. Isoniazid preventive therapy was received by 12.2% of participants, a rate that was not significantly different among the four study arms (<i>P</i>=0.122) and the newly diagnosed cases.</p><p><strong>Conclusion: </strong>Se supplementation, alone and with MVT, decreased the incidence of TB disease in PLWH who were ART-naïve. Supplementation with these micronutrients should be considered in HIV infection, prior to ART, in areas where TB and malnutrition are endemic.</p>","PeriodicalId":43423,"journal":{"name":"Nutrition and Dietary Supplements","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cf/34/nihms893644.PMC5703420.pdf","citationCount":"0","resultStr":"{\"title\":\"The effect of micronutrient supplementation on active TB incidence early in HIV infection in Botswana.\",\"authors\":\"Adriana Campa, Marianna K Baum, Hermann Bussmann, Sabrina Sales Martinez, Mansour Farahani, Erik van Widenfelt, Sikhulile Moyo, Joseph Makhema, Max Essex, Richard Marlink\",\"doi\":\"10.2147/NDS.S123545\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Coinfection with active tuberculosis (TB) is one of the leading causes of death in people living with HIV (PLWH) in Africa. 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引用次数: 0
摘要
背景：合并感染活动性肺结核（TB）是导致非洲艾滋病病毒感染者（PLWH）死亡的主要原因之一。这项调查探讨了微量营养素补充剂在预防艾滋病病毒感染者合并活动性肺结核中的作用：方法：2004 年至 2009 年期间，在博茨瓦纳的抗逆转录病毒治疗新手（未接受过抗逆转录病毒治疗）艾滋病病毒感染者中开展了一项随机营养补充试验。该研究采用因子设计，分为四组：单独硒（Se）组、单独含有维生素 B 群、维生素 C 和维生素 E 的多种维生素（MVT）组、Se+MVT 组合组和安慰剂组。曾经或目前患有活动性肺结核的参与者以及患有晚期艾滋病的参与者（CD4 结果）均被排除在外：四组参与者的基线特征无明显差异。在多变量调整模型中，与安慰剂相比，单独补充 Se（危险比=0.20，95% 置信区间：0.04，0.95，P=0.043）和两个 SE 组合组（Se 和 Se+MVT）患结核病的风险显著降低（危险比=0.32，95% 置信区间：0.11，0.93，P=0.036）。单独服用多种维生素不会影响结核病的发病率。12.2%的参与者接受了异烟肼预防治疗，这一比例在四个研究组和新诊断病例中没有显著差异（P=0.122）：结论：在抗逆转录病毒疗法无效的 PLWH 中，单独补充 Se 或同时补充 MVT 可降低结核病的发病率。在结核病和营养不良流行的地区，艾滋病毒感染者在接受抗逆转录病毒疗法之前应考虑补充这些微量营养素。
The effect of micronutrient supplementation on active TB incidence early in HIV infection in Botswana.
Background: Coinfection with active tuberculosis (TB) is one of the leading causes of death in people living with HIV (PLWH) in Africa. This investigation explores the role of micronutrient supplementation in preventing active TB in PLWH.
Methods: A randomized trial of nutritional supplementation was conducted among antiretroviral- naïve (without previous antiretroviral treatment [ART]) HIV-infected people in Botswana between 2004 and 2009. The study had a factorial design with four arms: the selenium (Se) alone arm, the multivitamins (MVT) alone arm that contained vitamin B complex and vitamins C and E, the combined Se+MVT group and the placebo group. Those participants with prior or current active TB were excluded, as were participants with advanced HIV disease (CD4 <250 cells/μL) or who had already qualified for ART. HIV-positive adults (N=878) were followed monthly for study pill dispensation, every 3 months for CD4 cell count and every 6 months for viral load during 24 months or until they were started on ART.
Results: The participants' characteristics were not significantly different among the four groups at baseline. Supplementation with Se alone (hazard ratio =0.20, 95% confidence interval: 0.04, 0.95, P=0.043) and the two combined SE groups (Se and Se+MVT) had significantly lower risk of developing incident TB disease compared with placebo in multivariate adjusted models (hazard ratio=0.32, 95% confidence interval: 0.11, 0.93, P=0.036). Multivitamins alone did not affect the incidence of TB. Isoniazid preventive therapy was received by 12.2% of participants, a rate that was not significantly different among the four study arms (P=0.122) and the newly diagnosed cases.
Conclusion: Se supplementation, alone and with MVT, decreased the incidence of TB disease in PLWH who were ART-naïve. Supplementation with these micronutrients should be considered in HIV infection, prior to ART, in areas where TB and malnutrition are endemic.
期刊介绍：
Nutrition and Dietary Supplements is an international, peer-reviewed, open access journal focusing on research into nutritional requirements in health and disease, impact on metabolism and the identification and optimal use of dietary strategies and supplements necessary for normal growth and development. Specific topics covered in the journal include: Epidemiology, prevalence of related disorders such as obesity, diabetes, dyslipidemias Biochemistry and cellular metabolism of nutrients Effect of nutrition on metabolic control Impact of hormones and genetics on nutrient handling Identification of cofactors and development of effective supplementation strategies Dietary strategies Behavior modification Consumer and patient adherence, quality of life Public Health Policy & Health Economics.
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