Type 2 diabetes is associated with pulmonary cavitation in men with HIV-TB coinfection

Objectives To explore the association between type 2 diabetes mellitus (T2D) and pulmonary cavitation in male with HIV-tuberculosis (TB) coinfection, as well as to quantify the relationships between glycemic indicators [HbA1c and fasting plasma glucose (FPG)] and cavity size. The robustness of these correlations was further validated in a non-HIV TB sample. Methods This comparative cross-sectional study based on exposure status included 132 men with HIV-TB and T2D (exposed group) and 131 age-matched men with HIV-TB without T2D (non-exposed group). Multivariable regression models, subgroup analyses, and interaction tests were used to evaluaterelationships and effect modification. A validation cohort of 100 non-HIV TB patients was analyzed using the same analytical framework. Results In men coinfected with HIV and TB, T2D was linked to a higher incidence of pulmonary cavitation (adjusted OR = 3.892, 95% CI = 1.895-7.992, P Conclusion T2D is a significant risk factor for pulmonary cavitation in males with HIV-TB coinfection, and poor glycemic management is linked with increased cavity size. Sputum-positive patients with T2D represent an exceptionally high-risk subgroup. Incorporating glycemic evaluation and optimal metabolic management into TB care may assist to lower cavitation risk in this population.