Pre-Post Assessment of Serum Zinc and Copper Status in Uncomplicated Pulmonary Tuberculosis Patients Receiving Directly Observed Treatment Short Course

Abstract

Mycobacterium tuberculosis causing the infectious disease tuberculosis has a predilection for the lungs although it is common to see other organs involved. India has adopted the TB-DOTS program for the treatment of the same. Undernutrition and tuberculosis are mutually inclusive. Micronutrients like zinc and copper play a key role in cytokine kinetics and immunity and thus are important in an individual’s response to infectious disease. Serum copper and zinc levels in patients with pulmonary tuberculosis (pTB) before and after two months of directly observed treatment short course (DOTS) were assessed in this study. The serum samples of 39 pTB patients were collected before the commencement of anti-tubercular therapy (ATT) and tested for copper and zinc levels. At the end of the intensive phase of treatment, blood samples of 31 out of the 39 pTB patients were again collected and tested for the same trace elements. In the pre-post comparison of 31 patients who could be followed up, an increase in serum zinc levels [101 (74.9) μg/ dl vs 112(155.5) μg/dl)] after the treatment was not statistically significant (p=0.15). The serum copper levels [184(105.7) μg/dl vs 247(80.8) μg/dl)] were significantly (p<0.01) increased after two months of DOTS therapy. Sputum negativity was close to 81%.Serum copper, as well as zinc levels, were increased after DOTS therapy for two months. Since the response to therapy was 69%, supplementation of copper and zinc may benefit the pTB patients in achieving sputum negativity sooner and completely.