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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">A Trial of the Effect of Micronutrient Supplementation on Treatment Outcome, T Cell Counts, Morbidity, and Mortality in Adults with Pulmonary Tuberculosis</title><author><name sortKey="Villamor, Eduardo" sort="Villamor, Eduardo" uniqKey="Villamor E" first="Eduardo" last="Villamor">Eduardo Villamor</name><affiliation><nlm:aff id="A1">Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Mugusi, Ferdinand" sort="Mugusi, Ferdinand" uniqKey="Mugusi F" first="Ferdinand" last="Mugusi">Ferdinand Mugusi</name><affiliation><nlm:aff id="A5">Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Urassa, Willy" sort="Urassa, Willy" uniqKey="Urassa W" first="Willy" last="Urassa">Willy Urassa</name><affiliation><nlm:aff id="A6">Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Bosch, Ronald J" sort="Bosch, Ronald J" uniqKey="Bosch R" first="Ronald J." last="Bosch">Ronald J. Bosch</name><affiliation><nlm:aff id="A3">Center for Biostatistics in AIDS Research and Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Saathoff, Elmar" sort="Saathoff, Elmar" uniqKey="Saathoff E" first="Elmar" last="Saathoff">Elmar Saathoff</name><affiliation><nlm:aff id="A7">Department of Tropical Medicine, University of Munich, Munich, Germany</nlm:aff></affiliation></author><author><name sortKey="Matsumoto, Kenji" sort="Matsumoto, Kenji" uniqKey="Matsumoto K" first="Kenji" last="Matsumoto">Kenji Matsumoto</name><affiliation><nlm:aff id="A1">Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Meydani, Simin N" sort="Meydani, Simin N" uniqKey="Meydani S" first="Simin N." last="Meydani">Simin N. Meydani</name><affiliation><nlm:aff id="A4">Nutritional Immunology Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging, Department of Pathology at the Sackler Graduate School of Biochemical Sciences, and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W." last="Fawzi">Wafaie W. Fawzi</name><affiliation><nlm:aff id="A1">Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">18471061</idno><idno type="pmc">2564793</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564793</idno><idno type="RBID">PMC:2564793</idno><idno type="doi">10.1086/587846</idno><date when="2008">2008</date><idno type="wicri:Area/Pmc/Corpus">000F79</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000F79</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">A Trial of the Effect of Micronutrient Supplementation on Treatment Outcome, T Cell Counts, Morbidity, and Mortality in Adults with Pulmonary Tuberculosis</title><author><name sortKey="Villamor, Eduardo" sort="Villamor, Eduardo" uniqKey="Villamor E" first="Eduardo" last="Villamor">Eduardo Villamor</name><affiliation><nlm:aff id="A1">Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Mugusi, Ferdinand" sort="Mugusi, Ferdinand" uniqKey="Mugusi F" first="Ferdinand" last="Mugusi">Ferdinand Mugusi</name><affiliation><nlm:aff id="A5">Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Urassa, Willy" sort="Urassa, Willy" uniqKey="Urassa W" first="Willy" last="Urassa">Willy Urassa</name><affiliation><nlm:aff id="A6">Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</nlm:aff></affiliation></author><author><name sortKey="Bosch, Ronald J" sort="Bosch, Ronald J" uniqKey="Bosch R" first="Ronald J." last="Bosch">Ronald J. Bosch</name><affiliation><nlm:aff id="A3">Center for Biostatistics in AIDS Research and Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Saathoff, Elmar" sort="Saathoff, Elmar" uniqKey="Saathoff E" first="Elmar" last="Saathoff">Elmar Saathoff</name><affiliation><nlm:aff id="A7">Department of Tropical Medicine, University of Munich, Munich, Germany</nlm:aff></affiliation></author><author><name sortKey="Matsumoto, Kenji" sort="Matsumoto, Kenji" uniqKey="Matsumoto K" first="Kenji" last="Matsumoto">Kenji Matsumoto</name><affiliation><nlm:aff id="A1">Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Meydani, Simin N" sort="Meydani, Simin N" uniqKey="Meydani S" first="Simin N." last="Meydani">Simin N. Meydani</name><affiliation><nlm:aff id="A4">Nutritional Immunology Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging, Department of Pathology at the Sackler Graduate School of Biochemical Sciences, and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts</nlm:aff></affiliation></author><author><name sortKey="Fawzi, Wafaie W" sort="Fawzi, Wafaie W" uniqKey="Fawzi W" first="Wafaie W." last="Fawzi">Wafaie W. Fawzi</name><affiliation><nlm:aff id="A1">Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation><affiliation><nlm:aff id="A2">Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts</nlm:aff></affiliation></author></analytic><series><title level="j">The Journal of infectious diseases</title><idno type="ISSN">0022-1899</idno><idno type="eISSN">1537-6613</idno><imprint><date when="2008">2008</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title><p id="P1">Tuberculosis (TB) often coincides with nutritional deficiencies. The effects of micronutrient supplementation on TB treatment outcomes, clinical complications, and mortality are uncertain.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">We conducted a randomized, double-blind, placebo-controlled trial of micronutrients (vitamins A, B complex, C, and E, as well as selenium) in Dar es Salaam, Tanzania. We enrolled 471 human immunodeficiency virus (HIV)–infected and 416 HIV-negative adults with pulmonary TB at the time of initiating chemotherapy and monitored them for a median of 43 months.</p></sec><sec id="S3"><title>Results</title><p id="P3">Micronutrients decreased the risk of TB recurrence by 45% overall (95% confidence interval [CI], 7% to 67%; <italic>P</italic> = .02) and by 63% in HIV-infected patients (95% CI, 8% to 85%; <italic>P</italic> = .02). There were no significant effects on mortality overall; however, we noted a marginally significant 64% reduction of deaths in HIV-negative subjects (95% CI, −14% to 88%; <italic>P</italic> = .08). Supplementation increased CD3<sup>+</sup> and CD4<sup>+</sup> cell counts and decreased the incidence of extrapulmonary TB and genital ulcers in HIV-negative patients. Micronutrients reduced the incidence of peripheral neuropathy by 57% (95% CI, 41% to 69%; <italic>P</italic> < .001), irrespective of HIV status. There were no significant effects on weight gain, body composition, anemia, or HIV load.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Micronutrient supplementation could improve the outcome in patients undergoing TB chemotherapy in Tanzania.</p></sec></div></front></TEI><pmc article-type="research-article" xml:lang="EN"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0413675</journal-id><journal-id journal-id-type="pubmed-jr-id">4830</journal-id><journal-id journal-id-type="nlm-ta">J Infect Dis</journal-id><journal-title>The Journal of infectious diseases</journal-title><issn pub-type="ppub">0022-1899</issn><issn pub-type="epub">1537-6613</issn></journal-meta><article-meta><article-id pub-id-type="pmid">18471061</article-id><article-id pub-id-type="pmc">2564793</article-id><article-id pub-id-type="doi">10.1086/587846</article-id><article-id pub-id-type="manuscript">NIHMS68423</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>A Trial of the Effect of Micronutrient Supplementation on Treatment Outcome, T Cell Counts, Morbidity, and Mortality in Adults with Pulmonary Tuberculosis</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Villamor</surname><given-names>Eduardo</given-names></name><xref rid="A1" ref-type="aff">1</xref><xref rid="A2" ref-type="aff">2</xref></contrib><contrib contrib-type="author"><name><surname>Mugusi</surname><given-names>Ferdinand</given-names></name><xref rid="A5" ref-type="aff">5</xref></contrib><contrib contrib-type="author"><name><surname>Urassa</surname><given-names>Willy</given-names></name><xref rid="A6" ref-type="aff">6</xref></contrib><contrib contrib-type="author"><name><surname>Bosch</surname><given-names>Ronald J.</given-names></name><xref rid="A3" ref-type="aff">3</xref></contrib><contrib contrib-type="author"><name><surname>Saathoff</surname><given-names>Elmar</given-names></name><xref rid="A7" ref-type="aff">7</xref></contrib><contrib contrib-type="author"><name><surname>Matsumoto</surname><given-names>Kenji</given-names></name><xref rid="A1" ref-type="aff">1</xref></contrib><contrib contrib-type="author"><name><surname>Meydani</surname><given-names>Simin N.</given-names></name><xref rid="A4" ref-type="aff">4</xref></contrib><contrib contrib-type="author"><name><surname>Fawzi</surname><given-names>Wafaie W.</given-names></name><xref rid="A1" ref-type="aff">1</xref><xref rid="A2" ref-type="aff">2</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts</aff><aff id="A2"><label>2</label>Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts</aff><aff id="A3"><label>3</label>Center for Biostatistics in AIDS Research and Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts</aff><aff id="A4"><label>4</label>Nutritional Immunology Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging, Department of Pathology at the Sackler Graduate School of Biochemical Sciences, and Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts</aff><aff id="A5"><label>5</label>Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</aff><aff id="A6"><label>6</label>Department of Microbiology and Immunology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania</aff><aff id="A7"><label>7</label>Department of Tropical Medicine, University of Munich, Munich, Germany</aff><author-notes><corresp id="FN1">Reprints or correspondence: Dr. E. Villamor, Dept. of Nutrition, Harvard School of Public Health, 665 Huntington Ave., Boston, MA 02115 (<email>evillamo@hsph.harvard.edu</email>)</corresp></author-notes><pub-date pub-type="nihms-submitted"><day>20</day><month>9</month><year>2008</year></pub-date><pub-date pub-type="ppub"><day>1</day><month>6</month><year>2008</year></pub-date><pub-date pub-type="pmc-release"><day>1</day><month>6</month><year>2009</year></pub-date><volume>197</volume><issue>11</issue><fpage>1499</fpage><lpage>1505</lpage><related-article journal-id-type="nlm-ta" journal-id="J Infect Dis" related-article-type="commentary" page="1487" id="N0x1c4fc50N0x27cf300" xlink:href="18471060" ext-link-type="pubmed" vol="197"></related-article><abstract><sec id="S1"><title>Background</title><p id="P1">Tuberculosis (TB) often coincides with nutritional deficiencies. The effects of micronutrient supplementation on TB treatment outcomes, clinical complications, and mortality are uncertain.</p></sec><sec sec-type="methods" id="S2"><title>Methods</title><p id="P2">We conducted a randomized, double-blind, placebo-controlled trial of micronutrients (vitamins A, B complex, C, and E, as well as selenium) in Dar es Salaam, Tanzania. We enrolled 471 human immunodeficiency virus (HIV)–infected and 416 HIV-negative adults with pulmonary TB at the time of initiating chemotherapy and monitored them for a median of 43 months.</p></sec><sec id="S3"><title>Results</title><p id="P3">Micronutrients decreased the risk of TB recurrence by 45% overall (95% confidence interval [CI], 7% to 67%; <italic>P</italic> = .02) and by 63% in HIV-infected patients (95% CI, 8% to 85%; <italic>P</italic> = .02). There were no significant effects on mortality overall; however, we noted a marginally significant 64% reduction of deaths in HIV-negative subjects (95% CI, −14% to 88%; <italic>P</italic> = .08). Supplementation increased CD3<sup>+</sup> and CD4<sup>+</sup> cell counts and decreased the incidence of extrapulmonary TB and genital ulcers in HIV-negative patients. Micronutrients reduced the incidence of peripheral neuropathy by 57% (95% CI, 41% to 69%; <italic>P</italic> < .001), irrespective of HIV status. There were no significant effects on weight gain, body composition, anemia, or HIV load.</p></sec><sec id="S4"><title>Conclusions</title><p id="P4">Micronutrient supplementation could improve the outcome in patients undergoing TB chemotherapy in Tanzania.</p></sec></abstract><contract-num rid="AI1">U01 AI045441-01</contract-num><contract-sponsor id="AI1">National Institute of Allergy and Infectious Diseases Extramural Activities : NIAID</contract-sponsor></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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