Vitamin D nutrient to treat TB begs the prevention question.

摘要

In The Lancet, Adrian Martineau and colleagues report a randomised multicentre trial of vitamin D_3 (colecalciferol) as adjunctive therapy for active tuberculosis, This study, and five other ongoing trials, were all designed to show faster recovery from active infection with Mycobacterium tuberculosis. Martineau and colleagues showed that the addition of vitamin D_3 shortened the time to sputum clearance by 1 week, from 43.5 to 36.0 days, but the decrease did not reach conventional statistical significance. For patients possessing the tt genotype oftheTaql vitamin D receptor polymorphism, vitamin D_3 produced a remarkable acceleration in clearance of mycobacilli from sputum. For the other subgroups with active disease in all the trials, the conclusion must await a future meta-analysis. However, no one is addressing whether activation of latent tuberculosis might have been prevented if vitamin D nutritional status had not been so low in these patients.