The standard course of the tuberculosis process, as a rule, is accompanied by low serum concentrations of vitamin A and zinc ions, which can negatively affect the severity of cellular immunity of the host organism. However, the effect of additional vitamin A and zinc administration on the results of TB treatment remains unclear.

There is an opinion, supported by the results of several studies, that the additional appointment of vitamins and minerals to the main treatment of tuberculosis within two months leads to an improvement in clinical results. However, this position is perceived ambiguously, and there are opponents of this approach, who argue that adding to the main treatment does not affect its outcome (according to the results of recent studies in Tanzania and Indonesia). Consequently, the researchers' interest in evaluating the positive effect of the additional administration of vitamin A and zinc over time to achieve complete conversion of the smears and the absence of growth of mycobacteria during the culture studies. , as well as the duration of the isolation of a pure culture from sputum of bacterial excrement, is understandable.

In this study, conducted by a team of scientists from the University of the Western Cape in Cape Town, an improved methodology to assess the clinical effect was used, including the weekly collection of sputum with bacterioscopic and bacteriological studies. It is known that differences in the results obtained by these methods can vary considerably, due to the experience and professional skills of the staff. In addition, the patients who participated in this study had a more brilliant evolution of the tuberculosis process compared to the previous subjects, which could also affect the time necessary to obtain a complete conversion of the smears and to obtain a negative growth of the culture.

The study included patients at a tuberculosis clinic in Cape Town, South Africa (n = 154), who were randomized into two groups: those who received additional vitamin A (200,000 IU palmitate retinol daily) and the trace element zinc (15 mg Zn daily) for 8 weeks and received a placebo. The primary treatment for tuberculosis was the same for all study participants. Sputum was collected weekly for 8 weeks, followed by bacterioscopy and isolation of a pure culture on a liquid nutrient medium (BACTEC MGIT 960; Becton Dickinson, Sparks, MD). At the start of the study and after 8 weeks (dynamic), the patient's objective state, chest radiographs, anthropometric data (body weight) were carefully evaluated.

Twenty people were infected with HIV (13%), including nine from the group receiving additional treatment, 11 from the placebo group. Twelve HIV statuses were unknown (8%).

After 8 weeks, 73% of study participants in the additional treatment group and 65% of the placebo group underwent smears underwent complete smears, and negative culture growth was recorded in 60% and 51% of patients, respectively. In both groups, there was a significant increase in the serum vitamin A concentration compared to the baseline. At the same time, no similar dynamics were observed with regard to the concentration of zinc ions in each of the groups.

During Kaplan-Meyer's analysis during the study, no difference was found in time to obtain a complete conversion of the smears and to obtain a negative result of the growth of the mycobacterial culture between the groups ( p = 0.15 and p = 0.38, respectively; log-rank analysis). The duration of isolation of mycobacteria by the cultural method was closely linked to the fact of the recurrent course of tuberculosis, while, as shown by a log regression analysis, no significant difference between the groups was revealed ( p = 0.32). There was also no statistically significant difference between the groups in the increase in body weight (2.3 ± 3.5 kg vs 2.2 ± 2.4 kg, p = 0.68) or the pathological focus resolution on the radiographs at the start of the study and after 8 weeks of dynamic therapy.

Thus, the additional use of vitamins and minerals does not affect the outcome of the treatment of pulmonary tuberculosis.

The problem of increasing the effectiveness of anti-tuberculosis treatment is not losing its relevance. According to the principal investigator, Dr. Visser, a group of researchers authorized by the World Health Organization, is currently conducting a detailed analysis of a study on the additional use of vitamins and minerals for the treatment of tuberculosis. However, to resolve any differences and doubts regarding this treatment tactic, further longer and larger randomized clinical trials are needed.