XDR-TB is associated with a much higher mortality rate than MDR-TB, because of a reduced number of effective treatment options. A 2008 study in the Tomsk oblast of Russia, reported that 14 out of 29 (48.3%) patients with XDR-TB successfully completed treatment. In 2018, the WHO reported that the treatment success rate for XDR-TB was 34% for the 2015 cohort, compared to 55% for MDR/RR-TB (2015 cohort), 77% for HIV-associated TB (2016 cohort), and 82% for TB (2016 cohort).A 2018 meta-analysis of 12,030 patients from 25 countries in 50 studies has demonstrated that treatment success increases and mortality decreases when treatment includes bedaquiline, later generation fluoroquinolones, and linezolid. One regimen for XDR-TB called Nix-TB, a combination pretomanid, bedaquiline, and linezolid, has shown promise in early clinical trials.Successful outcomes depend on a number of factors including the extent of the drug resistance, the severity of the disease and whether the patients immune system is compromised. It also depends on access to laboratories that can provide early and accurate diagnosis so that effective treatment is provided as soon as possible. Effective treatment requires that all six classes of second-line drugs be available to clinicians who have special expertise in treating such cases. Enforced quarantine
Carriers who refuse to wear a mask in public have been indefinitely involuntarily committed to regular jails, and cut off from contacting the world. Some have run away from the USA, complaining of abuse. Epidemiology
Studies have found that men have a higher risk of getting XDR-TB than women.
Excessive free fatty acid production by various tissues leads to increased VLDL synthesis by the liver. Initially, most VLDL is converted into LDL until this mechanism is saturated, after which VLDL levels elevate. Treatment
Both conditions are treated with fibrate drugs, which act on the peroxisome proliferator-activated receptors (PPARs), specifically PPARα, to decrease free fatty acid production. Statin drugs, especially the synthetic statins (atorvastatin and rosuvastatin), can decrease LDL levels by increasing hepatic reuptake of LDL due to increased LDL-receptor expression. See also
Hyperlipidemia

References


== External links ==