Nurul Aliyah S.1, Emmy H. Pranggono2, Basti Andriyoko3
1Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Padjadjaran, Bandung
2Divisi Respirologi dan Respirasi Kritis Departemen Ilmu Penyakit Dalam, Fakultas Kedokteran Universitas Padjadjaran, Bandung 3Departemen Patologi Klinik, Fakultas Kedokteran Universitas Padjadjaran, Bandung

ABSTRACT
Background: The incidence of Tuberculosis (TB) infection has increased throughout the years with a high mortality rate. The clinical manifestation of TB is a result of interaction between bacterial virulence, host immunity, and environmental factor. Nutritional component, such as vitamin D, plays a significant role in the host immune system. Vitamin D magnifies anti tuberculosis response toward macrophage. There was no data regarding vitamin D level in accordance to new cases of TB.
Objective: to describe the sputum smear conversion and vitamin D level in accordance to new cases of TB.
Methods: This study was performed in multicenter health facilities. Patient that has been confirmed with new case of TB and met the inclusion and exclusion criteria was enrolled to this study. The follow-up was done within 2 months. The data on socio demography, anthropometry, baseline vitamin D level, and conversion parameter were collected. Vitamin D level was differentiated into 3 categories: normal, insufficient, and deficient. In the 7 months period (October 2014-April 2015), 109 subjects were enrolled: 88 completed the follow-up, 20 dropped out, and 1 died. Results: In the study of 88 subjects, there were 55 people (62.5%) with sputum conversion and 33 people (37.5%) with non sputum conversion. The results of vitamin D levels were normal in 15 people (17%), insufficient in 29 people (33%), and deficient in 44 people (50%). Sputum conversion occurred in 9 people (16.4%) in the normal vitamin D group, 16 people (29.1%) in insufficient group, and 30 people (54.5%) in the deficient group. It means that conversion didn’t occur in 6 people (18.2%) in normal group, 13 people (39.4%) in insufficient group, and 14 people (42.4%) in deficient group.
Conclusion: People with vitamin D deficiency had both the highest number of subjects who experienced sputum conversion, and didn’t experience sputum conversion. This results indicated that there are other factors that play a role in TB infection, such as VDR polymorphism. This interaction will manifest especially in patients with low level of vitamin D. Further investigation should be done in order to evaluate the correlation between VDR polymorphism with TB infection.
Keywords : Sputum conversion, therapy, tuberculosis, vitamin D