991. Vitamin D Supplementation for Tuberculosis: Systematic Review and Meta-analysis of Randomised Controlled Trials
Session: Poster Abstract Session: Clinical Studies of Tuberculosis
Saturday, October 22, 2011
Room: Poster Hall B1
Handouts
  • vit D poster.pdf (335.9 kB)
  • Background: 

    Vitamin D has an antimicrobial effect in in-vitro studies. Levels are often deficient in patients with tuberculosis. Vitamin D supplementation may benefit patients receiving treatment for tuberculosis. Our objectives were to assess the impact on mortality and sputum conversion of vitamin D supplementation, compared with placebo or no treatment, for patients receiving treatment for tuberculosis.

    Methods: 

    Randomised controlled trials of patients receiving treatment for tuberculosis and either vitamin D supplementation or placebo/no treatment were considered eligible. There were no limits on language, publication status or publication date. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, published in The Cochrane Library, 2011, Issue 1), Medline from OVID (February 2011), EMBASE (February 2011), International Standard Randomised Controlled Trials Number Register (February 2011) and reference lists of relevant articles. The two authors independently selected studies, extracted data and performed risk of bias assessment. Outcome data from studies with similar outcomes were pooled. Dichotomous outcomes were expressed as risk ratios (RR) and standardised mean differences (SMD) were calculated from continuous variables.  

    Results: 

    Four trials were included, comprising 584 participants. There were no significant differences between patients receiving vitamin D supplementation and placebo in terms of mortality (RR 1.18, 95% confidence interval 0.73 to 1.93) and sputum culture positivity (RR sputum culture positive at 8 weeks 1.08, 95% CI 0.51 to 2.27).  There was a significant benefit for the vitamin D supplementation group in terms of sputum smear positivity rates at 6 weeks (RR 0.35, 95% CI 0.15 to 0.82), but this benefit was not maintained at 8 weeks, 5 months and 8 months. Two studies were small in size. Allocation concealment was not described in 3 trials. Blinding of healthcare providers and outcome assessors was not described in 2 studies. 

    Conclusion: 

    There is not sufficient evidence currently to demonstrate that administration of vitamin D supplementation benefits patients receiving treatment for tuberculosis. Further trials into this research question are ongoing and should clarify any benefit.


    Subject Category: C. Clinical studies of bacterial infections and antibacterials including sexually transmitted diseases and mycobacterial infections (surveys, epidemiology, and clinical trials)

    David P Gallagher, MRCPI, Dept of Infectious Diseases, University Hospital Galway, Galway, Ireland, Katie McFaul, MRCPI, Department of Infectious Diseases, University Hospital Galway, Galway, Ireland and Martin O Donnell, PhD, School of Medicine, NUI Galway, Galway, Ireland

    Disclosures:

    D. P. Gallagher, None

    K. McFaul, None

    M. O Donnell, None

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