The influence of nutritional deficiency on the course and outcomes of tuberculosis

• Polina D. Merzlikina
• Rizvan Yu. Abdullaev
• Oksana G. Komissarova
• Ekaterina A. Burlyaeva
• Atadzhan E. Ergeshov

Abstract

The effectiveness of tuberculosis treatment in the Russian Federation remains low compared to WHO targets. Along with other factors, nutritional deficiencies play a significant role in adverse tuberculosis outcomes.

The study objective was to analyze and summarize data characterizing the role of nutritional deficiencies in the development, course, and outcome of tuberculosis.

Material and methods. Sixty one literature sources were analyzed, using PubMed, Scopus, Elsevier, and eLIBRARY databases, as well as the Google Scholar search engine by keywords: pulmonary tuberculosis, nutritional status, malnutrition, protein-energy malnutrition; search depth 10 years (2015–2025).

Results. The analysis of the data examining the impact of malnutrition on the development, course, and outcomes of tuberculosis has shown that nutritional deficiency leads to a weakening of the innate and adaptive immune response and creates a biological environment conducive to the development of tuberculosis. Malnutrition is a risk factor for the transition from latent to active tuberculosis infection. Furthermore, malnutrition is associated with a higher incidence of severe forms of tuberculosis, including bacterial excretion and destructive changes in the lungs. Due to altered absorption, distribution, metabolism, and elimination of drugs, the risk of adverse reactions and decreased treatment effectiveness increases. Nutritional deficiency also elevates the risk of adverse clinical outcomes, such as death and relapse. Nutritional support aimed at improving nutritional status can enhance the effectiveness of treatment for patients with pulmonary tuberculosis.

Conclusion. The lack of comprehensive study data of malnutrition markers, including indicators of energy metabolism and bioimpedance analysis, in patients suffering from tuberculosis dictates the need to study various aspects of the body’s protein and energy supply and develop individual programs to correct existing disorders.

Keywords: tuberculosis; nutritional deficiency; protein-energy malnutrition; progression and outcomes of tuberculosis; immune system; treatment effectiveness

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