Background: Vitamin D deficiency (VDD) is a worldwide disease. VDD is also associated with an increased risk of HIV-related comorbidities and mortality, and patients have a tendency to develop active tuberculosis compared to those with latent tuberculosis infection. Vitamin D supplementation may modulate HIV replication, improve TB inflammation and reduce progression of HIV-TB co-infection.
Methods: We meta-analyzed individual participant data from cohort studies, cross-sectional study, and RCTs of vitamin D in HIV group, TB group, and HIV-TB group. The primary outcomes were differences in vitamin D level and VDD prevalence between three groups, the secondary outcomes were CD4 count, HIV viral load, time to sputum smear conversion, time to culture conversion, relapse, morality, and TB score.
Results: For vitamin D levels, the overall mean difference (MD) between HIV group and TB group was -0.21 (95% CI, -20.80-20.38; = 0.9, = 84%), HIV group and HIV-TB group was 0.87 (95% CI, -11.45-13.20; = 0.89, = 87%), and TB group and HIV-TB group was 1.17 (95% CI, -5.21-7.55; = 0.72, = 85%). For vitamin D deficiency prevalence, the overall odds ratio (OR) for HIV group versus TB group was 1.23 (95% CI, 0.46-3.31; = 0.68; = 70%), HIV group versus HIV-TB group was 1.53 (95% CI, 1.03-2.29; = 0.04; = 0%), and TB group versus HIV-TB group was 0.85 (95% CI, 0.61-1.20; = 0.36; = 22%). In HIV-TB group, the overall OR for vitamin D group versus placebo group was 0.78 (95% CI, 0.34-1.67; = 0.52; = 60%).
Conclusion: Our findings indicated that there were no variations in vitamin D levels between three groups. The prevalence of vitamin D deficiency was higher in the HIV-TB group than in the HIV group. Additionally, the administration of vitamin D supplements did not have obvious impact on CD4 count and viral load. Likewise, vitamin D had no effect on time to sputum smear conversion, time to culture conversion, relapse, 12-month morality, and TB score.
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http://dx.doi.org/10.3389/fpubh.2024.1344024 | DOI Listing |
PLoS One
January 2025
Division of Global HIV & TB, US Centers for Disease Control and Prevention, Atlanta, GA, United States of America.
Background: In Uganda, adolescent girls', and young women's (AGYW-15-24 years) current HIV prevalence is fourfold compared with their male counterparts due to compounded social, economic, and environmental factors. Using the Protective Motivation Theory (PMT), we explored HIV-acquisition risk sources and perceived protective factors from AGYW and caregivers' perspective.
Materials And Methods: During 2018, we conducted a qualitative study guided by PMT to explore factors influencing HIV acquisition among AGYW.
BMC Health Serv Res
January 2025
HIV and Other Infectious Diseases Research Unit (HIDRU), South African Medical Research Council: CAPRISA-MRC HIV-TB Pathogenesis and Treatment Research Unit, Free State, South Africa.
Background: Despite advances in drug-resistant tuberculosis (DR-TB) diagnosis, treatment, and service delivery, individuals with DR-TB often face significant socioeconomic and psychosocial challenges due to limited resources. These challenges can hinder retention in care, undermining the progress made in DR-TB management. As a consequence, advances in DR-TB diagnostics and treatment have not resulted in DR-TB programs meeting the 75% treatment success targets set by the World Health Organization (WHO).
View Article and Find Full Text PDFF1000Res
January 2025
Faculty of Medicine and Health Sciences, Division of Epidemiology and Biostatistics, Stellenbosch University Centre for Evidence-Based Health Care, Cape Town, South Africa.
Background: Tuberculosis (TB) is a leading cause of death worldwide with over 90% of reported cases occurring in low- and middle-income countries (LMICs). Pre-treatment loss to follow-up (PTLFU) is a key contributor to TB mortality and infection transmission.
Objectives: We performed a scoping review to map available evidence on interventions to reduce PTLFU in adults with pulmonary TB, identify gaps in existing knowledge, and develop a conceptual framework to guide intervention implementation.
BMC Med Educ
January 2025
Department of International Public Health, Emergency Obstetric and Quality of Care Unit, Liverpool School of Tropical Medicine, Pembrooke Place, L3, 5QA, Liverpool, UK.
Background: The blended learning (BL) approach to training health care professionals is increasingly adopted in many countries because of high costs and disruption to service delivery in the light of severe human resource shortage in low resource settings. The Covid-19 pandemic increased the urgency to identify alternatives to traditional face-to-face (f2f) education approach. A four-day f2f antenatal care (ANC) and postnatal care (PNC) continuous professional development course (CPD) was repackaged into a 3-part BL course; (1) self-directed learning (16 h) (2) facilitated virtual sessions (2.
View Article and Find Full Text PDFLancet Reg Health Am
December 2024
Centre for Tuberculosis Research, Departments of International Public Health and Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK.
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