The effect of micronutrient supplementation on active TB incidence early in HIV infection in Botswana

Adriana Campa,1 Marianna K Baum,1 Hermann Bussmann,2 Sabrina Sales Martinez,1 Mansour Farahani,3 Erik van Widenfelt,2 Sikhulile Moyo,2,3 Joseph Makhema,2 Max Essex,2,3 Richard Marlink3 1Department of Dietetics and Nutrition, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA; 2Botswana Harvard AIDS Institute Partnership, Gaborone, Botswana; 3The Harvard T.H. Chan School of Public Health, Boston, MA, USA Background: Coinfection with active tuberculosis (TB) is one of the leading causes of death in people living with HIV (PLWH) in Africa. This investigation explores the role of micronutrient supplementation in preventing active TB in PLWH. Methods: A randomized trial of nutritional supplementation was conducted among antiretroviral-naïve (without previous antiretroviral treatment [ART]) HIV-infected people in Botswana between 2004 and 2009. The study had a factorial design with four arms: the selenium (Se) alone arm, the multivitamins (MVT) alone arm that contained vitamin B complex and vitamins C and E, the combined Se+MVT group and the placebo group. Those participants with prior or current active TB were excluded, as were participants with advanced HIV disease (CD4