The purpose of this study is to determine the efficacy of micronutrient supplementation among patients with active tuberculosis, half of who are co-infected with HIV-1

Tuberculosis (TB) remains the single most common infectious disease cause of mortality. We propose to examine the inter- relationships of nutrition, immunology, and epidemiology with respect to TB in Tanzania. Given that TB is so much linked with HIV immunologically, clinically, and epidemiologically, it is essential to examine how these relationships are modified by HIV infection. Published animal and human studies suggest that vitamin deficiency is associated with poor immune response in TB. By modulating immune function, nutritional supplements may be a useful adjunct to anti-TB drugs, and could lead to the development of shorter drug regimens. All patients will receive standard anti-TB therapy. Follow-up visits will occur every two weeks for the first 2 months and monthly thereafter till the end of the study.

Inclusion Criteria:

• Men and women, age 18 to 60 years inclusive
• At least two positive sputum smears for tuberculosis
• Intention to stay in Dar-es-Salaam for at least 2 years after the start of TB therapy
• Subjects who grant informed consent to participation

Exclusion Criteria:

• Karnofsky score < 40%
• Hemoglobin < 8.5 g/dl
• Having had treatment for TB exceeding 4 weeks in the last 5 years
• Pregnant women