Can a TB patient recover

Cochrane

Cochrane authors conducted a review examining the effects of dietary supplements in people treated for tuberculosis. The search for suitable studies was ended on February 4, 2016 and 35 relevant studies were included with a total of 8283 participants. All results found are summarized below.

What is active tuberculosis and how might dietary supplements work?

Tuberculosis is a bacterial infection that commonly affects the lungs. Most people who become infected never develop symptoms because their immune system keeps the bacteria under control. Active tuberculosis occurs when the immune system can no longer suppress the infection. Typical symptoms are cough, chest pain, fever, night sweats, weight loss, and sometimes coughing up blood. Treatment involves a combination of antibiotics that are taken for at least six months.

People with tuberculosis are often malnourished, putting them at higher risk of developing tuberculosis because their immune systems are weakened. Dietary supplements could help people recover from the disease by strengthening the immune system and improving weight gain and muscle strength, allowing people to return to active lives. Good nutrition requires the daily intake of macronutrients (carbohydrates, proteins and fat) and micronutrients (essential vitamins and minerals).

What does the research say?

Effect of the provided food supplements on people in the context of tuberculosis treatment

We do not currently know whether offering free meals to tuberculosis patients in the form of hot meals or food packages will reduce deaths or improve healing ( very low quality of evidence ). However, it probably improves weight gain in some settings (moderate quality of evidence) and could improve the quality of life (low quality evidence.

Regular micronutrient supplements may have little or no effect on deaths in HIV-negative people with tuberculosis (low quality evidence) or HIV-positive people who are not receiving antiretroviral therapy (moderate quality of evidence ). We do not currently know whether micronutrient supplementation will have any effect on tuberculosis treatment endpoints (very low quality of evidence), but it is unlikely to have any effect on weight gain (low quality evidence). None of the included studies collected data on quality of life.

Vitamin A plasma levels seem to increase after starting tuberculosis treatment, regardless of dietary supplements. In contrast, dietary supplements appear to improve plasma levels of zinc, vitamin D, vitamin E, and selenium, but this is not considered to be an important clinical benefit. Despite several studies on dietary supplements with vitamin D in various doses, no statistically significant benefits on the negative effects of sputum could be demonstrated.

Authors' conclusions

Dietary supplements or energy supplements may be useful for weight gain during recovery from tuberculosis in some settings. But there is currently no evidence that it improves tuberculosis treatment endpoints. In addition, there is currently no reliable evidence that dietary supplements routinely taken in excess of the recommended daily amount have any clinical benefit.