Email updates

Keep up to date with the latest news and content from BMC Infectious Diseases and BioMed Central.

Open Access Highly Accessed Research article

Vitamin D accelerates clinical recovery from tuberculosis: results of the SUCCINCT Study [Supplementary Cholecalciferol in recovery from tuberculosis]. A randomized, placebo-controlled, clinical trial of vitamin D supplementation in patients with pulmonary tuberculosis’

Nawal Salahuddin1*, Farheen Ali2, Zahra Hasan3, Nisar Rao4, Masooma Aqeel5 and Faisal Mahmood6

Author affiliations

1 Consultant Department of Adult Critical Care Medicine, King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia

2 Section of Infectious Disease, Department of Medicine, Aga Khan University, Karachi, Pakistan

3 Department of Pathology and Microbiology, Aga Khan University, Karachi, Pakistan

4 Department of Pulmonology, Ojha Institute of Chest Diseases, Karachi, Pakistan

5 Section of Pulmonary and Critical Care Medicine, Department of Medicine, Aga Khan University, Karachi, Pakistan

6 Section of Infectious Disease, Department of Medicine, Aga Khan University, Karachi, Pakistan

For all author emails, please log on.

Citation and License

BMC Infectious Diseases 2013, 13:22  doi:10.1186/1471-2334-13-22

Published: 19 January 2013

Abstract

Background

Vitamin D enhances host protective immune responses to Mycobacterium tuberculosis by suppressing Interferon-gamma (IFN-g) and reducing disease associated inflammation in the host. The objectives of this study were to determine whether vitamin D supplementation to patients with tuberculosis (TB) could influence recovery.

Methods

Two hundred and fifty nine patients with pulmonary TB were randomized to receive either 600,000 IU of Intramuscular vitamin D3 or placebo for 2 doses. Assessments were performed at 4, 8 and 12 weeks. Early secreted and T cell activated 6 kDa (ESAT6) and Mycobacterium tuberculosis sonicate (MTBs) antigen induced whole blood stimulated IFN-g responses were measured at 0 and 12 weeks. Statistical comparisons between outcome variables at 0 and 12 weeks were performed using Student’s t-test and Chi2 tests.

Results

After 12 weeks, the vitamin D supplemented arm demonstrated significantly greater mean weight gain (kg) + 3.75, (3.16 – 4.34) versus + 2.61 (95% CI 1.99 – 3.23) p 0.009 and lesser residual disease by chest radiograph; number of zones involved 1.35 v/s 1.82 p 0.004 (95% CI 0.15, 0.79) and 50% or greater reduction in cavity size 106 (89.8%) v/s 111 (94.8%), p 0.035. Vitamin D supplementation led to significant increase in MTBs-induced IFN-g secretion in patients with baseline ‘Deficient’ 25-hydroxyvitamin D serum levels (p 0.021).

Conclusions

Supplementation with high doses of vitamin D accelerated clinical, radiographic improvement in all TB patients and increased host immune activation in patients with baseline ‘Deficient’ serum vitamin D levels. These results suggest a therapeutic role for vitamin D in the treatment of TB.

Trial registration

ClinicalTrials.gov; No. NCT01130311; URL: clinicaltrials.gov