Plasma vitamins and essential trace elements in multi-drug resistant tuberculosis patients before and during chemotherapy

Multi-drug-resistant tuberculosis (MDR-TB) is caused by Mycobacterium tuberculosis (Mtb) strain resistant to both rifampicin and isoniazid. Nigeria has an estimated MDR-TB rate of 2.9% and 14.3% among new and relapse cases respectively and is ranked among 4 high burden African countries for MDR-TB. Malnutrition has been implicated in the progression from dormant to active disease. This study determined the plasma level of micronutrients (Fe, Zn, Cu, vitamins A, C, D and E) in MDR-TB patients before and throughout anti-TB chemotherapy. Plasma iron, zinc, copper, vitamins A, C, D and E were determined in twenty-four (24) MDR-TB patients before the commencement of anti-TB chemotherapy, 2 months, 4 months and 6 months post-commencement of anti-TB chemotherapy, as well as in twenty (20) healthy controls. Plasma vitamin A level was significantly decreased before chemotherapy compared with controls. At 2 months of anti-TB treatment there were significant decreases in plasma levels of iron, vitamins A, C and E compared to controls whereas plasma zinc level was significantly increased compared with levels before treatment. At 4 months of treatment, plasma levels of copper and vitamin D were significantly increased while plasma vitamin E level was reduced significantly compared with controls. There were significant increases in iron, zinc, copper, vitamin A and vitamin D levels with decreased plasma levels of vitamins C and E at 4 months of treatment compared with their levels before chemotherapy. At 6 months of treatment, plasma levels of iron, zinc, copper and vitamin D were significantly increased while vitamin E was significantly decreased compared with controls. Plasma levels of iron, zinc, copper, vitamins A and D were significantly increased whereas the levels of vitamins C and E were significantly reduced at 6 months of treatment compared with levels before chemotherapy. Plasma levels of iron, zinc, copper, vitamins A and D were raised while plasma levels of vitamins E and C were reduced in MDR-TB patients from 4 months post commencement of anti-TB chemotherapy. Thus, there is need to monitor micronutrient supplementation and plasma levels of these micronutrients to avoid complications associated with overload or deficiency. (C) 2016 The Egyptian Society of Chest Diseases and Tuberculosis. Production and hosting by Elsevier B.V.