Vitamin D levels in patients with active TB: Is it clinically relevant?

Background: Vitamin D supplementation alongside standard combination antibiotics has been reported to lead to a faster rate of sputum culture conversion in individuals with tuberculosis (TB) [1]. However, a large placebo controlled trial reported no benefit of vitamin D supplementation in the rate of culture conversion [2]. In the UK, the National Institute for Health and Clinical Excellence (NICE) suggests seeking specialist advice when considering vitamin D supplementation in TB. Aim: Assess the clinical features and management of patients treated for active TB with and without vitamin D deficiency. Methods: The clinical records of all patients diagnosed with TB in a large teaching hospital over a three year period (2015-17) were reviewed. Demographic information, vitamin D status, and vitamin D supplementation were recorded. Results: 206 patients were diagnosed with TB over the 3 year period (62% male, median age 40.5; IQR 30-56). Vitamin D levels were checked at the beginning or during treatment in only 76 patients (37%). 54 of these patients were vitamin D deficient, and 25 of these were severely deficient (vitamin D Conclusion: Our findings suggests a shortfall in clinical practice, as vitamin D levels were not frequently checked, but deficiency was present in a substantial proportion of patients assessed. The role of vitamin D in TB therapy remains unclear. References 1) Hassanein et al. Egypt J Chest Dis Tuberc 2016;65:629–635 2) Ganmaa et al. AJRCCM 2017;196:628-637