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

36 Citations (Scopus)

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.

Original languageEnglish
JournalJournal of Nutrition
Volume141
Issue number4
Pages (from-to)685-691
Number of pages7
ISSN0022-3166
DOIs
Publication statusPublished - 1 Apr 2011

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