Abstract
COVID-19 pandemic has sparked active discussion about the interactions between COVID-19, tuberculosis, and HIV.
The purpose of the study is to conduct a comprehensive assessment of the immunological, clinical, and organizational aspects of the interactions between COVID-19, tuberculosis, and HIV, based on literature review.
Materials and methods. This review study was conducted using a systematic search and analysis of scientific publications on the co-infections of COVID-19, tuberculosis, and HIV. A search for publications from 2020 to 2025 was conducted in the international electronic databases PubMed, Google Scholar, Scopus, and the Russian scientific electronic library eLibrary.ru.
Results. One of the main practical challenges is the difficulty in distinguishing COVID-19 from tuberculosis due to similar symptoms, such as cough and fever. This often leads to a late diagnosis of one disease in the presence of the other. The combined course of COVID-19 and tuberculosis, referred to as the «collision of two pandemics» is more severe and more than doubles the risk of death from COVID-19. From an immunological perspective, the combined course of infections disrupts the regulation of the inflammatory response. SARS-CoV-2 can disrupt a balanced immune response to tuberculosis infection, potentially triggering the reactivation of latent tuberculosis. Key mechanisms include cytokine imbalance (such as TNF-α, IFN-γ, and IL-6) and decreased T-lymphocyte count and function, which are necessary to control both infections. The presence of triple infection (COVID-19/TB/HIV) significantly worsens the prognosis. Furthermore, disruptions to healthcare systems during the pandemic have threatened years of progress in the fight against tuberculosis and HIV.
Conclusion. Despite advances in understanding immune mechanisms, many issues related to the diagnosis and management of patients with co-infections, especially in the presence of HIV, require further study.