Active TB 3.5 X more likely if low Vitamin D - 15th meta-analysis

Association of vitamin D deficiency with active and latent tuberculosis: A meta-analysis and trial sequential analysis

Indian J. of Tuberculosis Volume 73, Issue 2, April 2026, Pages 236-244 https://doi.org/10.1016/j.ijtb.2025.08.003 PDF behind paywall, references are free

Namitha , Priyanka , Monika Sharma , Sadhna Sharma - India

Background Globally, tuberculosis (TB) is a significant health issue, and both latent and active TB pose considerable public health risks. Adequate vitamin D is crucial in immune regulation, and its deficiency raise the odds of developing TB. There is still uncertainty about the link between vitamin D deficiency (VDD) and TB, mainly regarding latent TB infection.

Objective This meta-analysis and Trial Sequential Analysis (TSA) aim to review the association between VDD and active and latent TB.

Methods A systematic search of literatures across PubMed and Google Scholar, identified 3623 studies. Following the selection criteria, 34 studies on active TB and 10 studies on latent TB were retrieved. The meta-analysis was performed to assess the odds ratios (ORs) with 95 % confidence intervals (CIs), while TSA was employed to validate findings and minimize random errors.

Results It was found through the meta-analysis that there is a positive association between VDD and TB. Active TB patients had a pooled OR of 3.55 (95 % CI = 2.42–5.20), indicating a higher prevalence of VDD compared to healthy controls. Latent TB patients also showed a significant association, with OR 1.26 (95 % CI = 1.10–1.45). TSA confirmed that the cumulative evidence was sufficient to establish this association without the need for further trials in latent TB patients.

Conclusion These findings reinforce the link of VDD with both active and latent TB, suggesting that vitamin D status may influence TB susceptibility. The findings call for more studies on the correlation of vitamin D and TB, and should prioritize vitamin D testing in TB patients.