Literartur Review: Impact of Multidrug-resistant Tuberculosis on Hemoglobin Levels
Keywords:
Hemoglobin, Linezolid, MDR-TBAbstract
Abstract. Multidrug-resistant tuberculosis (MDR-TB) requires complex treatment regimens that are frequently associated with hematological adverse effects, particularly due to the use of linezolid. This literature review aims to evaluate the impact of MDR-TB treatment regimens on hemoglobin (Hb) levels. A narrative review was conducted using studies retrieved from electronic databases, including PubMed, Google Scholar, and Scopus, which examined hemoglobin changes and anemia in patients receiving MDR-TB therapy. The reviewed literature consistently demonstrates that MDR-TB treatment significantly affects hemoglobin levels. Long-term and short-term regimens are associated with a higher risk of hemoglobin reduction and anemia, mainly due to prolonged exposure to linezolid. In contrast, shorter regimens such as BPaL/M tend to show a more favorable hematological profile. This benefit is attributable not only to the shorter duration of therapy but also to simpler and less complex drug combinations, which may reduce cumulative hematological toxicity. Mitochondrial dysfunction leading to impaired erythropoiesis is identified as the primary mechanism underlying linezolid-associated anemia. These findings highlight the importance of selecting treatment regimens that balance therapeutic efficacy with hematological safety and underscore the need for regular hemoglobin monitoring during MDR-TB treatment.
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