Adjunctive micronutrient supplementation for pulmonary tuberculosis

objective: to assess the effect of micronutrient supplementation on tuberculosis (tb) patient outcomes. material and methods: the randomized, double-blinded, placebo-controlled study was conducted in pulmonary tb patients undergoing directly observed treatment short course/ tratamiento acortado estrictamente supervisado (taes/ dots) at imss in ciudad juarez, chihuahua, mexico, who were recruited during august 2005-july 2006. consecutive patients received zinc and vitamin a supplements or matched placebo for four months. dietary intake, blood zinc and vitamin a, immune response (ifn-γ,tnf-α, and il-10 mrna), and sputum smear conversion were measured. results: the proportion of micronutrient compared to placebo group subjects with a negative sputum smear by month 3 was significantly increased (p= 0.03). this occurred subsequent to increased tnf-α and ifn-γ and decreased il-'0 observed at month 2. micronutrient supplementation appeared to accelerate the beneficial therapeutic effect of chemotherapy. conclusions: the earlier elimination of bacilli from sputum was associated with improved zinc status and th' immune response. the therapeutic effect of vitamin a was less evident.