Nutritional Supplementation Increases Rifampin Exposure among Tuberculosis Patients Coinfected with HIV

Jeremiah, Kidola; Denti, Paolo; Cosson, E.; Faurholt‐Jepsen, Daniel; PrayGod, George; Range, Nyagosya; Castel, Sandra; Wiesner, Lubbe; Hagen, Christian Munch; Christiansen, Michael; Changalucha, John; McIlleron, Helen; Friis, Henrik; Andersen, Aase Bengaard

doi:10.1128/aac.02307-13

Cited by 59 publications

(90 citation statements)

References 30 publications

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“…Praygod 2011b TZA included only HIV-positive patients and although the trend was towards a benefit this did not reach statistical significance. Jeremiah 2014 TZA noted a greater increase in mean weight gain in the supplemented group compared to the non-supplemented group after 8 weeks; however the difference was not appreciable (1.09 kg, P < 0.6, authors' own figures). The 3 other trials all demonstrated clinically important benefits.…”

Section: Summary Of Findings For the Main Comparisonmentioning

confidence: 81%

“…Eleven trials specifically included people with HIV, and presented some results separately for HIV positive and HIV negative participants (Schön 2003 ETH; Range 2005 TZA; Semba 2007 MWI; Villamor 2008 TZA; Wejse 2008 GNB; Lawson 2010 NGA; Mehta 2011 TZA; Sudarsanam 2010 IND; Schön 2011 ETH; Ralph 2013 IDN; Jeremiah 2014 TZA). Four of the trials that presented results for HIV-positive and HIV-negative participants separately used stratified randomization (Villamor 2008 TZA; Wejse 2008 GNB; Sudarsanam 2010 IND; Jeremiah 2014 TZA), but six tested participants for HIV following randomization (Schön 2003 ETH; Range 2005 TZA; Semba 2007 MWI; Lawson 2010 NGA; Mehta 2011 TZA; Schön 2011 ETH), and therefore the subgroup analyses by HIV status cannot be said to be truly randomized.…”

Section: Resultsmentioning

confidence: 99%

“… 1 Three trials reported some deaths during the 6 months of treatment (Jahnavi 2010 IND; Jeremiah 2014 TZA; Sudarsanam 2010 IND), and 1 reported that no deaths occurred (Martins 2009 TLS). The trials were conducted in Tanzania, Timor-Leste, and India in participants with signs of undernutrition.…”

Section: Summary Of Findings For the Main Comparisonmentioning

confidence: 99%

“…The trials were conducted in Tanzania, Timor-Leste, and India in participants with signs of undernutrition. Martins 2009 TLS gave a daily hot meal, Sudarsanam 2010 IND gave monthly ration packs, Jahnavi 2010 IND gave daily locally appropriate supplements, and Jeremiah 2014 TZA gave high energy multivitamin enriched biscuits. 2 Downgraded by 1 for indirectness: trials are only available from limited settings. Food supplementation would plausibly have its biggest effect in highly food-insecure or emergency settings which are not reflected in these trials.…”

Section: Summary Of Findings For the Main Comparisonmentioning

confidence: 99%

Section: Summary Of Findings For the Main Comparisonmentioning

confidence: 99%

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Nutritional supplements for people being treated for active tuberculosis

Grobler

Nagpal

Sudarsanam

et al. 2016

Cochrane Database of Systematic Reviews

160

117

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Background Tuberculosis and malnutrition are linked in a complex relationship. Tuberculosis may cause undernutrition through increased metabolic demands and decreased intake, and nutritional deficiencies may worsen the disease, or delay recovery by depressing important immune functions. At present, there is no evidence‐based nutritional guidance for adults and children being treated for tuberculosis. Objectives To assess the effects of oral nutritional supplements in people being treated with antituberculous drug therapy for active tuberculosis. Search methods We searched the Cochrane Infectious Disease Group Specialized Register, Cochrane Central Register of Controlled Trials (CENTRAL; Issue 1, 2016), MEDLINE (from 1946 to 4 February 2016), EMBASE (from 1980 to 4 February 2016), LILACS (from 1982 to 4 February 2016), the meta Register of Controlled Trials ( m RCT), the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP), and the Indian Journal of Tuberculosis up to 4 February 2016, and checked the reference lists of all included studies. Selection criteria Randomized controlled trials that compared any oral nutritional supplement given for at least four weeks with no nutritional intervention, placebo, or dietary advice only for people being treated for active tuberculosis. The primary outcomes of interest were all‐cause death, and cure at six and 12 months. Data collection and analysis Two review authors independently selected trials for inclusion, and extracted data and assessed the risk of bias in the included trials. We presented the results as risk ratios (RR) for dichotomous variables, and mean differences (MD) for continuous variables, with 95% confidence intervals (CIs). Where appropriate, we pooled data from trials with similar interventions and outcomes. We assessed the quality of the evidence using the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Main results Thirty‐five trials, including 8283 participants, met the inclusion criteria of this review. Macronutrient supplementation Six trials assessed the provision of free food, or high‐energy supplements. Only two trials measured total dietary intake, and in both trials the intervention increased calorie consumption compared to controls. The available trials were too small to reliably prove or exclude clinically important benefits on mortality (RR 0.34, 95% CI 0.10 to 1.20; four trials, 567 participants, very low quality evidence ), cure (RR 0.91, 95% CI 0.59 to 1.41; one trial, 102 participants, very low quality evidence ), or treatment completion (data not pooled; two trials, 365 participants, very low quality evi...

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Section: Summary Of Findings For the Main Comparisonmentioning

confidence: 81%

Section: Resultsmentioning

confidence: 99%

Section: Summary Of Findings For the Main Comparisonmentioning

confidence: 99%

Section: Summary Of Findings For the Main Comparisonmentioning

confidence: 99%

Section: Summary Of Findings For the Main Comparisonmentioning

confidence: 99%

See 3 more Smart Citations

Nutritional supplements for people being treated for active tuberculosis

Grobler

Nagpal

Sudarsanam

et al. 2016

Cochrane Database of Systematic Reviews

160

117

View full text Add to dashboard Cite

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Community-based supplementary feeding for food insecure, vulnerable and malnourished populations - an overview of systematic reviews

Visser

McLachlan

Maayan

et al. 2018

Cochrane Database of Systematic Reviews

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BackgroundSupplementary feeding may help food insecure and vulnerable people by optimising the nutritional value and adequacy of the diet, improving quality of life and improving various health parameters of disadvantaged families. In low‐ and middle‐income countries (LMIC), the problems supplementary feeding aims to address are entangled with poverty and deprivation, the programmes are expensive and delivery is complicated.Objectives1. To summarise the evidence from systematic reviews of supplementary feeding for food insecure, vulnerable and malnourished populations, including children under five years of age, school‐aged children, pregnant and lactating women, people with HIV or tuberculosis (or both), and older populations.2. To describe and explore the effects of supplementary feeding given to people in these groups, and to describe the range of outcomes between reviews and range of effects in the different groups.MethodsIn January 2017, we searched the Cochrane Database of Systematic Reviews, MEDLINE, Embase and nine other databases. We included systematic reviews evaluating community‐based supplementary feeding, and concerning food insecure, vulnerable and malnourished populations. Two review authors independently undertook selection of systematic reviews, data extraction and 'Risk of bias' assessment. We assessed review quality using the AMSTAR tool, and used GRADEpro 'Summary of findings' tables from each review to indicate the certainty of the evidence for the main comparisons. We summarised review findings in the text and reported the data for each outcome in additional tables. We also used forest plots to display results graphically.Main resultsThis overview included eight systematic reviews (with last search dates between May 2006 and February 2016). Seven were Cochrane Reviews evaluating interventions in pregnant women; children (aged from birth to five years) from LMIC; disadvantaged infants and young children (aged three months to five years); children with moderate acute malnutrition (MAM); disadvantaged school children; adults and children who were HIV positive or with active tuberculosis (with or without HIV). One was a non‐Cochrane systematic review in older people with Alzheimer's disease. These reviews included 95 trials relevant to this overview, with the majority (74%) of participants from LMIC.The number of included participants varied between 91 and 7940 adults, and 271 and more than 12,595 children. Trials included a wide array of nutritional interventions that varied in duration, frequency and format, with micronutrients often reported as cointerventions. Follow‐up ranged from six weeks to two years; three trials investigated outcomes at four to 17 years of age. All reviews were rated as high quality (AMSTAR score between eight and 11). The GRADE certainty ratings ranged from very low to moderate for individual comparisons, with the evidence often comprising only one or two small trials, thereby resulting in many underpowered analyses (too small to detect small but important differences...

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Pharmacokinetics and Pharmacodynamics of Intensive Antituberculosis Treatment of Tuberculous Meningitis

Ding

Thuong

Pham

et al. 2020

Clin Pharma and Therapeutics

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The most effective antituberculosis drug treatment regimen for tuberculous meningitis is uncertain. We conducted a randomized controlled trial comparing standard treatment with a regimen intensified by rifampin 15 mg/kg and levofloxacin for the first 60 days. The intensified regimen did not improve survival or any other outcome. We therefore conducted a nested pharmacokinetic/pharmacodynamic study in 237 trial participants to define exposure–response relationships that might explain the trial results and improve future therapy. Rifampin 15 mg/kg increased plasma and cerebrospinal fluid (CSF) exposures compared with 10 mg/kg: day 14 exposure increased from 48.2 hour·mg/L (range 18.2–93.8) to 82.5 hour·mg/L (range 8.7–161.0) in plasma and from 3.5 hour·mg/L (range 1.2–9.6) to 6.0 hour·mg/L (range 0.7–15.1) in CSF. However, there was no relationship between rifampin exposure and survival. In contrast, we found that isoniazid exposure was associated with survival, with low exposure predictive of death, and was linked to a fast metabolizer phenotype. Higher doses of isoniazid should be investigated, especially in fast metabolizers.

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Nutritional Supplementation Increases Rifampin Exposure among Tuberculosis Patients Coinfected with HIV

Cited by 59 publications

References 30 publications

Nutritional supplements for people being treated for active tuberculosis

Nutritional supplements for people being treated for active tuberculosis

Community-based supplementary feeding for food insecure, vulnerable and malnourished populations - an overview of systematic reviews

Pharmacokinetics and Pharmacodynamics of Intensive Antituberculosis Treatment of Tuberculous Meningitis

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