Advances in tuberculosis co-infections: Mechanisms, diagnosis, and therapeutics

Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis, which is widespread and harmful worldwide. It can attack multiple organs throughout the body, with pulmonary tuberculosis being the most common. The Global Tuberculosis Report 2024 shows an increase in the incidence of TB from the previous year, and its transmission is closely linked to the response of the host immune system. In clinical settings, co-infections with other pathogens are becoming more common. 10.8 million new TB cases were diagnosed globally in 2023, of which 662,000 were co-infected with HIV, and the risk of death in patients with TB-HIV co-infections with HIV is three times higher than in patients with TB alone. Such co-infections significantly increase the complexity of the disease and the difficulty of diagnosis and treatment, and may further exacerbate the global burden of TB through a combination of immunosuppression, primary resistance due to the spread of drug resistance, and the extension of the chain of transmission, making it an important challenge for global public health to address. In this review, we will discuss some common pathogens that are co-infected with TB, with the aim of sorting out the related research progress and providing reference for the subsequent TB control.