Daily multi-micronutrient supplementation during tuberculosis treatment increases weight and grip strength among HIV-uninfected but not HIV-infected patients in Mwanza, Tanzania

George PrayGod, Nyagosya Range, Daniel Faurholt-Jepsen, Jeremiah Kidola, Maria Faurholt-Jepsen, Martine G. Aabye, Lotte Jensen, Andreas V. Jensen, Harleen M.S. Grewal, Pascal Magnussen, John Changalucha, Åse Bengård Andersen, Henrik Friis

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Abstract

Undernutrition is common among tuberculosis (TB) patients. The objective of this study was to assess the effect of multi-micronutrient supplementation during TB treatment on weight, body composition, and handgrip strength. A total of 865 patientswith smear-positive (PTB+) or -negative (PTB-) pulmonary TBwere randomly allocated to receive a daily biscuitwith or without multi-micronutrients for 60 d during the intensive phase of TB treatment.Weight, arm fat area, arm muscle area, and handgrip strength were assessed at baseline and after 2 and 5 mo. At 2 mo, the multi-micronutrient supplementation led to a higher handgrip gain (1.22 kg; 95% CI = 0.50, 1.94; P = 0.001) but had no effects on other outcomes. The effects of multimicronutrient supplementation were modified by HIV infection (P-interaction = 0.002). Among HIV- patients, multimicronutrient supplementation increased weight gain by 590 g (95% CI =240, 1210; P = 0.07) and handgrip strength by 1.6 kg (95%CI = 0.78, 2.47; P < 0.001), whereas among HIV+ patients, it reduced weight gain by 1440 g (95%CI = 290, 2590; P = 0.002) and had no effect on handgrip strength (0.07 kg; 95% CI =21.30, 1.46; P = 0.91). The reducedweight gain among HIV+ patients receiving multi-micronutrient supplementation seemed to be explained by a higher proportion of patients reporting fever. At 5mo, the effects on weight were sustained, whereas there was no effect on handgrip strength. In conclusion, multimicronutrient supplementation given as a biscuit is beneficial among HIV2 PTB patients and may be recommended to TB programs. More research is needed to develop an effective supplement for HIV+ PTB patients.

OriginalsprogEngelsk
TidsskriftJournal of Nutrition
Vol/bind141
Udgave nummer4
Sider (fra-til)685-691
Antal sider7
ISSN0022-3166
DOI
StatusUdgivet - 1 apr. 2011

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PrayGod, G., Range, N., Faurholt-Jepsen, D., Kidola, J., Faurholt-Jepsen, M., Aabye, M. G., Jensen, L., Jensen, A. V., Grewal, H. M. S., Magnussen, P., Changalucha, J., Andersen, Å. B., & Friis, H. (2011). Daily multi-micronutrient supplementation during tuberculosis treatment increases weight and grip strength among HIV-uninfected but not HIV-infected patients in Mwanza, Tanzania. Journal of Nutrition, 141(4), 685-691. https://doi.org/10.3945/jn.110.131672