Introduction:

Helminth and Mycobacterium tuberculosis infections overlap geographically, particularly in low- and middle-income countries, where they are highly endemic. There, most people are chronically infected by one or both types of pathogens early in their lives.

Objective:

To explore the main immunological aspects of helminth-M tuberculosis coinfection and its consequences for the progression of M. tuberculosis infection and vaccination against tuberculosis.

Methods:

A review of articles on immunology, diagnosis, treatment, and control of helminth and M. tuberculosis infections was conducted on those published between 2010-2022 in PubMed, Medline, and Google Scholar databases. In addition, some previously dated original monographs and articles were consulted.

Analysis and synthesis of information:

During chronic helminth infection, modulation of Th2 and Treg immune responses by these parasites could inhibit Th1 and Th17 immune responses against M. tuberculosis infection and lead to its progression from the latent phase, with little clinical expression, to the active phase of tuberculosis. Immune modulation of helminths could lead to poor response to BCG vaccination. Epidemiological results show that immunomodulation could be reversed by anthelmintic treatments.

Conclusions:

In chronic helminth infection, it is important to consider that the modulation of their immune responses activates complex immunoregulatory circuits that can lead to severe forms of tuberculosis in the host and poor response to BCG vaccination.

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