Vitamin D supplementation does not lower TB risk in children
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Vitamin D metabolites support innate immune responses to Mycobacterium tuberculosis. Data from phase 3, randomized, controlled trials of vitamin D supplementation to prevent tuberculosis infection are lacking.

Researchers randomly assigned children who had negative results for M. tuberculosis infection according to the QuantiFERON-TB Gold In-Tube assay (QFT) to receive a weekly oral dose of either 14,000 IU of vitamin D3 or placebo for 3 years. The primary outcome was a positive QFT result at the 3-year follow-up, expressed as a proportion of children. Secondary outcomes included the serum 25-hydroxyvitamin D (25[OH]D) level at the end of the trial and the incidence of tuberculosis disease, acute respiratory infection, and adverse events.

Results:
-- A total of 8851 children underwent randomization: 4418 were assigned to the vitamin D group, and 4433 to the placebo group; 95.6% of children had a baseline serum 25(OH)D level of less than 20 ng per milliliter.
-- Among children with a valid QFT result at the end of the trial, the percentage with a positive result was 3.6% in the vitamin D group and 3.3% (134 of 4043) in the placebo group.
-- The mean 25(OH)D level at the end of the trial was 31.0 ng per milliliter in the vitamin D group and 10.7 ng per milliliter in the placebo group.
-- Tuberculosis disease was diagnosed in 21 children in the vitamin D group and in 25 children in the placebo group.
-- A total of 29 children in the vitamin D group and 34 in the placebo group were hospitalized for treatment of acute respiratory infection.
-- The incidence of adverse events did not differ significantly between the two groups.

Conclusively, Vitamin D supplementation did not result in a lower risk of tuberculosis infection, tuberculosis disease, or acute respiratory infection than placebo among vitamin D–deficient schoolchildren in Mongolia.

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1915176?query=featured_home
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