Serum Vitamin D levels in patients of newly diagnosed microbiologically confirmed pulmonary tuberculosis

Background: Tuberculosis (TB) remains a major global health problem. Emerging evidence suggests that Vitamin D plays a significant immunomodulatory role in host defense against Mycobacterium tuberculosis. Vitamin D deficiency may predispose individuals to active TB and influence disease severity. Aims and Objectives: The aim of the study was to evaluate serum Vitamin D levels in newly diagnosed microbiologically confirmed pulmonary TB patients, assess its association with bacterial load, and determine changes after 2 months of anti-tubercular therapy (ATT). Materials and Methods: A prospective cohort study was conducted in 130 participants, including 65 newly diagnosed pulmonary TB patients and 65 age- and sex-matched healthy controls. Baseline serum 25-hydroxyvitamin D levels were measured in both groups. In cases, repeat estimation was performed after 2 months of ATT. Bacterial load was assessed using sputum smear grading. Statistical analysis included independent t-test, Chi-square test, analysis of variance, and Spearman correlation. Results: Baseline mean serum Vitamin D levels were significantly lower in cases (13.06±4.38 ng/mL) compared to controls (25.72±5.15 ng/mL) (P<0.0001). Vitamin D deficiency (<20 ng/mL) was present in 75.4% of cases versus 47.7% of controls (P=0.003). A significant inverse correlation was observed between baseline Vitamin D levels and sputum acid-fast bacilli grading (r=−0.388, P=0.001). After 2 months of ATT, mean Vitamin D levels increased significantly to 27.61±11.87 ng/mL (P<0.001). Conclusion: Vitamin D deficiency is highly prevalent in newly diagnosed pulmonary TB patients and is inversely associated with bacterial load. Significant improvement in Vitamin D levels after ATT suggests dynamic interaction between disease activity and Vitamin D metabolism. Routine screening of Vitamin D levels may be beneficial in pulmonary TB management.