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Background:Tuberculosis (TB) is one of the most debilitating diseases worldwide.Current studies have shown that vitamin D plays a significant role in host immune defense against Mycobacterium tuberculosis,but clinical trials reported inconsistent results.Therefore,we systematically reviewed the literature to investigate whether vitamin D supplementation could improve the effect of anti-TB therapy.Methods:We systematically searched PubMed,Embase,and the Cochrane Central Register of Controlled Trials from their inception to February 8th,2019 for randomized controlled trials on vitamin D supplementation in patients with pulmonary TB receiving anti-TB therapy.The primary outcomes were time to sputum culture and smear conversion and proportion of participants with negative sputum culture.The secondary outcomes were clinical response to treatment and adverse events.A random-effects model was used to pool studies.Data were analyzed using RevMan 5.3 software.Results:Five studies with a total of 1126 participants were included in our meta-analysis.Vitamin D supplementation did not shorten the time to sputum culture and smear conversion (hazard ratio [HR] 1.04,95％ confidence interval [CI] 0.89-1.23,P =0.60;HR 1.15,95％ CI 0.93-1.41,P =0.20,respectively) and did not lead to an increase in the proportion of participants with negative sputum culture (relative risk [RR] 1.04,95％ CI 0.97-1.11,P =0.32).However,it reduced the time to sputum culture conversion in the sub-group of participants with TaqI tt genotype (HR 8.09,95 ％ CI 1.39-47.09,P =0.02) and improved the multidrug-resistant (MDR) TB sputum culture conversion rate (RR 2.40,95 ％ CI 1.11-5.18,P =0.03).There was no influence on secondary outcomes.Conclusions:Vitamin D supplementation had no beneficial effect on anti-TB treatment,but it reduced the time to sputum culture conversion in participants with tt genotype of the TaqI vitamin D receptor gene polymorphism and improved the MDR TB sputum culture conversion rate.