Daily Multi-Micronutrient Supplementation during Tuberculosis Treatment Increases Weight and Grip Strength among HIV-Uninfected but Not HIV-Infected Patients in Mwanza, Tanzania.

Undernutrition is common among tuberculosis (TB) patients. The objective of this study was to assess the effect of multi- micronutrient supplementation during TB treatment on weight, body composition, and handgrip strength. A total of 865 patients with smear-positive IPTB+) or-negative IPTB-) pulmonary TB were randomly allocated to receive a daily biscuit with or without multi-micronutrients for 60 d during the intensive phase of TB treatment. Weight, arm fat area, arm muscle area, and handgrip strength were assessed at baseline and after 2 and 5 mo. At 2 mo, the multi-micronutrient supplementation led to a higher handgrip gain (1.22 kg; 95% CI = 0.50, 1.94; P= 0.0011 but had no effects on other outcomes. The effects of multi- micronutrient supplementation were modified by HIV infection (P-interaction = 0.002). Among HIV- patients, multi- micronutrient supplementation increased weight gain by 590 g (95% Cl = -40, 1210; P = 0.07) and handgrip strength by 1.6 kg (95% Cl = 0.78, 2.47; P< 0.0011, whereas among HIV+ patients, it reduced weight gain by 1440 g (95% Cl = 290, 2590; P= 0.0021 and had no effect on handgrip strength 10.07 kg; 95% Cl = -1.30, 1.46; P= 0.91). The reduced weight gain among HIV+ patients receiving multi-micronutrient supplementation seemed to be explained by a higher proportion of patients reporting fever. At 5 mo, the effects on weight were sustained, whereas there was no effect on handgrip strength. In conclusion, multi- micronutrient supplementation given as a biscuit is beneficial among HIV- PTB patients and may be recommended to TB programs. More research is needed to develop an effective supplement for HIV+ PTB patients. [ABSTRACT FROM AUTHOR]