Plasma vitamins and essential trace elements in multi-drug resistant tuberculosis patients before and during chemotherapy

Multi-drug-resistant tuberculosis (MDR-TB) is caused by Mycobacterium tuberculosis
(Mtb) strain resistant to both rifampicin and isoniazid. Nigeria has an estimated MDR-TB rate
of 2.9% and 14.3% among new and relapse cases respectively and is ranked among 4 high burden
African countries for MDR-TB. Malnutrition has been implicated in the progression from dormant
to active disease.
This study determined the plasma level of micronutrients (Fe, Zn, Cu, vitamins A, C, D and E) in
MDR-TB patients before and throughout anti-TB chemotherapy. Plasma iron, zinc, copper, vitamins
A, C, D and E were determined in twenty-four (24) MDR-TB patients before the commencement
of anti-TB chemotherapy, 2 months, 4 months and 6 months post-commencement of anti-TB
chemotherapy, as well as in twenty (20) healthy controls. Plasma vitamin A level was significantly
decreased before chemotherapy compared with controls. At 2 months of anti-TB treatment there
were significant decreases in plasma levels of iron, vitamins A, C and E compared to controls
whereas plasma zinc level was significantly increased compared with levels before treatment. At
4 months of treatment, plasma levels of copper and vitamin D were significantly increased while
plasma vitamin E level was reduced significantly compared with controls. There were significant
increases in iron, zinc, copper, vitamin A and vitamin D levels with decreased plasma levels of vitamins
C and E at 4 months of treatment compared with their levels before chemotherapy. At
6 months of treatment, plasma levels of iron, zinc, copper and vitamin D were significantly
increased while vitamin E was significantly decreased compared with controls. Plasma levels of iron,
zinc, copper, vitamins A and D were significantly increased whereas the levels of vitamins C and E
were significantly reduced at 6 months of treatment compared with levels before chemotherapy.