30-Second Takeaway
- Dolutegravir-based ART improved viral suppression, retention, and TB outcomes in a large rural South African cohort.
- Outpatient influenza antivirals and pediatric vaccination both reduced severe outcomes and healthcare utilization across recent seasons.
- Fidaxomicin preserved gut microbiota diversity in CDI, whereas vancomycin markedly depleted it, aligning with recurrence biology.
- Whole-genome sequencing for TB drug susceptibility was cost-saving and improved modeled outcomes versus culture and Xpert-based strategies.
- Universal SARS-CoV-2 screening of asymptomatic inpatients had low yield and substantial false-positive–related harms at low community incidence.
Week ending April 11, 2026
Practice-changing ID data in HIV, TB, influenza, CDI, febrile neutropenia, and SARS-CoV-2 screening
Dolutegravir rollout improves HIV program outcomes and lowers TB risk in rural South Africa
In a retrospective cohort of 69 919 adults with HIV in rural KwaZulu-Natal, about 70% transitioned to dolutegravir (DTG)-containing ART over 4 years. Compared with non-DTG regimens, DTG use was associated with higher viral suppression <400 copies/mL (aHR 1.24, 95% CI 1.10-1.29). DTG was also associated with better retention in care (aHR 1.20, 95% CI 1.11-1.30), indicating programmatic benefits beyond virologic efficacy. Importantly, DTG use correlated with lower incident tuberculosis risk (aHR 0.68, 95% CI 0.54-0.87) in this high-burden setting. These data support sustained DTG-based ART rollout, with ongoing monitoring of long-term outcomes and performance in similar programs.
Influenza antivirals in outpatients linked to lower hospitalization and mortality
Investigators used the TriNetX database to study 1 016 581 non-hospitalized influenza patients, comparing antiviral use within 2 days versus no antivirals. After 1:1 propensity matching, 426 275 patients per group showed lower hospitalization risk with antivirals (RR 0.91, 95% CI 0.85-0.95). Antiviral treatment was also associated with fewer emergency visits (RR 0.80), ICU admissions (RR 0.84), and deaths (RR 0.60). Among patients aged 2-64 years without high-risk comorbidities, antivirals still reduced hospitalization, emergency visits, and ICU admissions. These observational data support early outpatient antiviral treatment for confirmed influenza, while acknowledging potential residual confounding.
Gut microbiota recovery and antibiotic choice predict CDI recurrence risk
This longitudinal study followed 143 CDI patients with stool sampling at diagnosis, end of treatment, and 8 weeks or at recurrence. Non-recurrent cases showed significantly higher gut biodiversity at 8 weeks than at diagnosis, unlike recurrent cases. Vancomycin treatment significantly decreased diversity, whereas fidaxomicin preserved microbial diversity (no significant decline in Shannon index). Women and immunocompromised patients had impaired microbiota recovery, identifying groups potentially at higher recurrence risk. Fidaxomicin-treated samples also had higher Bacteroidetes abundance than vancomycin or vancomycin-bezlotuzumab, supporting microbiota-sparing regimens when feasible.
References
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Additional Reads
Optional additional studies from this edition.