Factors influencing the aggressive course of tuberculosis infection (review)

Objective: to identify the biological mechanisms that most significantly influence the aggressive progression of tuberculosis, including the relationship between metabolic disorders, immune response, and the resistance of Mycobacterium tuberculosis to drugs, considering current scientific understanding of the disease's pathogenesis. Methodology for writing a review. The study is based on materials from both Russian and international databases, including PubMed, Scopus, eLibrary and others. From an initial selection of 213 publications covering the period from 2019 to 2024, 43 of the most relevant works were chosen. Conclusion. The results of the study show that the progression of aggressive forms of tuberculosis depends on the complex interaction between metabolic disorders, immune response abnormalities, and the development of M. tuberculosis resistance to therapeutic drugs. These interconnected processes play a central role in the worsening of the disease, emphasizing the need for the implementation of comprehensive strategies for more effective treatment and prevention.