Lung cavitation is associated with heightened TB transmission and poor treatment outcomes. This study aimed to determine the relationship between systemic inflammation and lung cavitation in drug-resistant TB patients with and without HIV co-infection. Plasma samples were obtained from 128 participants from the CAPRISA 020 Individualized M(X)drug-resistant TB Treatment Strategy Study (InDEX) prior to treatment initiation. Lung cavitation was present in 61 of the 128 drug-resistant TB patients with 93 being co-infected with HIV. The plasma cytokine and chemokine levels were measured using the 27-Plex Human Cytokine immunoassay. Modified Poisson regression models were used to determine the association between plasma cytokine/chemokine expression and lung cavitation in individuals with drug-resistant TB. Higher Interleukin-6 plasma levels (adjusted risk ratio [aRR] 1.405, 95% confidence interval [CI] 1.079–1.829, p = 0.011) were associated with a higher risk of lung cavitation in the multivariable model adjusting for age, sex, body mass index, HIV status, smoking and previous history of TB. Smoking was associated with an increased risk of lung cavitation (aRR 1.784, 95% CI 1.167–2.729, p = 0.008). An HIV positive status and a higher body mass index, were associated with reduced risk of lung cavitation (aRR 0.537, 95% CI 0.371–0.775, p = 0.001 and aRR 0.927, 95% CI 0.874–0.983, p = 0.012 respectively). High plasma interleukin-6 levels are associated with an increased risk of cavitary TB highlighting the role of interleukin-6 in the immunopathology of drug-resistant TB.

中文翻译：

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较高的血浆白细胞介素 - 6 水平与耐药结核病中的肺空洞相关

肺空洞与结核病传播加剧和治疗结果不佳有关。本研究旨在确定合并或未合并 HIV 感染的耐药结核病患者全身炎症与肺空洞之间的关系。在开始治疗之前，从 CAPRISA 020 个体化 M(X) 耐药结核病治疗策略研究 (InDEX) 的 128 名参与者中获取血浆样本。128 名耐药结核病患者中有 61 名出现肺空洞，其中 93 名患者同时感染 HIV。使用 27-Plex 人类细胞因子免疫测定法测量血浆细胞因子和趋化因子水平。改良泊松回归模型用于确定耐药结核病个体血浆细胞因子/趋化因子表达与肺空化之间的关联。在调整年龄、性别、体型的多变量模型中，血浆白细胞介素 6 水平较高（调整后风险比 [aRR] 1.405，95% 置信区间 [CI] 1.079–1.829，p = 0.011）与较高的肺空化风险相关质量指数、艾滋病毒状况、吸烟和既往结核病史。吸烟与肺空洞风险增加相关（aRR 1.784，95% CI 1.167–2.729，p = 0.008）。HIV阳性状态和较高的体重指数与肺空洞风险降低相关（分别为aRR 0.537，95% CI 0.371-0.775，p = 0.001；aRR 0.927，95% CI 0.874-0.983，p = 0.012）。高血浆白细胞介素 6 水平与空洞结核病风险增加相关，这凸显了白细胞介素 6 在耐药结核病免疫病理学中的作用。