Vitamin D Deficiency and Tuberculosis Progression
Vitamin D Deficiency and Tuberculosis Progression
To assess the association between vitamin D deficiency and tuberculosis disease progression, we studied vitamin D levels in a cohort of tuberculosis patients and their contacts (N = 129) in Pakistan. Most (79%) persons showed deficiency. Low vitamin D levels were associated with a 5-fold increased risk for progression to tuberculosis.
Deficiency of vitamin D (25-hydroxycholecalciferol) has long been implicated in activation of tuberculosis (TB). Serum levels of vitamin D in TB patients are lower than in healthy controls. Paradoxically, prolonged treatment of TB also causes a decline in serum vitamin D levels. Several studies have suggested that vitamin D is a potent immunomodulator of innate immune responses by acting as a cofactor for induction of antimycobacterial activity. Of the 22 countries that have the highest TB incidence, Pakistan ranks eighth. In a previous study in Karachi, we observed that active disease developed in 7 (6.4%) of 109 TB case-contacts within 2 years. In the present study, we explored the role of vitamin D deficiency in TB disease progression within this cohort.
Abstract and Introduction
Abstract
To assess the association between vitamin D deficiency and tuberculosis disease progression, we studied vitamin D levels in a cohort of tuberculosis patients and their contacts (N = 129) in Pakistan. Most (79%) persons showed deficiency. Low vitamin D levels were associated with a 5-fold increased risk for progression to tuberculosis.
Introduction
Deficiency of vitamin D (25-hydroxycholecalciferol) has long been implicated in activation of tuberculosis (TB). Serum levels of vitamin D in TB patients are lower than in healthy controls. Paradoxically, prolonged treatment of TB also causes a decline in serum vitamin D levels. Several studies have suggested that vitamin D is a potent immunomodulator of innate immune responses by acting as a cofactor for induction of antimycobacterial activity. Of the 22 countries that have the highest TB incidence, Pakistan ranks eighth. In a previous study in Karachi, we observed that active disease developed in 7 (6.4%) of 109 TB case-contacts within 2 years. In the present study, we explored the role of vitamin D deficiency in TB disease progression within this cohort.