Background We aimed to evaluate outcomes of people with HIV-1 (PWH) initiating bictegravir/emtricitabine/tenofovir alafenamide (BIC/FTC/TAF) according to the presence or absence of advanced HIV-1 disease (AHD). Methods We conducted a multicenter retrospective cohort study of newly diagnosed PWH initiating BIC/FTC/TAF during 2019–2024. The primary outcome was ever achieving viral load (VL) measurement < 50 copies/mL within 48 ± 12 weeks, regardless of subsequent viral rebound. Associations between clinical and laboratory variables and outcomes were analysed using logistic regression and Fine-Gray subdistribution hazard models. Results Of 577 PWH (median CD4 counts, 225 cells/µL), 248 (43.0%) presented with AHD. Baseline VL > 100,000 copies/mL (adjusted odds ratio [aOR] 0.34; 95% confidence interval [CI] 0.18–0.66) and AHD (aOR 0.48; 95% CI 0.27–0.83) were associated with lower odds of achieving the primary outcome independently. Stratified by baseline VL of 100,000 copies/mL, the proportion achieving the primary outcome was significantly lower among PWH with AHD than among those without (76.1% vs 88.4%, P = 0.006) in the high VL subgroup. Conversely, proportions were similar by AHD status in the low VL subgroup (93.1% vs 94.0%, P = 0.78). Conclusion Virologic outcomes with BIC/FTC/TAF were not statistically different between PWH with and without AHD among those with baseline VL ≤ 100,000 copies/mL.
Respiratory syncytial virus (RSV) is a major cause of pediatric respiratory disease in Saudi Arabia, particularly among infants during the first six months of life. Saudi studies report RSV detection in approximately 20–26% of hospitalized children with respiratory illness, although estimates vary by population, setting, diagnostic method, and study period. RSV contributes substantially to hospitalization, intensive care admission, mechanical ventilation, and healthcare costs. Circulation is generally seasonal, from autumn to early spring, peaking in December and January, with regional variation and post-COVID-19 shifts. Both RSV-A and RSV-B circulate, highlighting the need for ongoing molecular surveillance. Prevention has historically relied on palivizumab for selected high-risk infants. Emerging strategies, including nirsevimab and maternal prefusion F vaccination, show substantial international effectiveness, although Saudi-specific effectiveness data remain unavailable. Broader infant prevention, strengthened surveillance, locally defined seasonal timing, real-world effectiveness studies, molecular monitoring, and comprehensive economic evaluation are therefore strongly warranted across Saudi Arabia.
Background: Treatment options for carbapenem-resistant Acinetobacter baumannii (CRAB) pneumonia remain limited, and conventional therapies carry substantial toxicity. Minocycline is a potential therapeutic alternative, but the comparative effectiveness and safety of minocycline-based regimens remain insufficiently characterized. We compared clinical outcomes and treatment-related adverse events across different minocycline-based regimens in patients with CRAB pneumonia. Methods: This single-center retrospective cohort included adults (≥18 years) who received oral minocycline-based regimens for CRAB pneumonia from January 2018 through September 2025. Treatment regimens included minocycline monotherapy (MIN), minocycline plus colistin (MIN+CST), minocycline plus ampicillin–sulbactam (MIN+SAM), and other minocycline-based combinations. The primary outcome was 28-day all-cause mortality. Secondary outcomes included acute kidney injury (AKI) and alanine aminotransferase (ALT) elevation. Mortality was analyzed using Cox regression with time-dependent treatment exposure, and AKI and ALT elevation using Fine–Gray competing-risk regression. Results: The final study cohort comprised 179 patients were included. Among the three main treatment groups, 28-day mortality was 23.0% for MIN, 34.9% for MIN + CST, and 16.9% for MIN + SAM with no significant difference (log-rank P = 0.126). No statistically significant association between treatment regimen and mortality was observed in multivariable analysis. MIN + CST was associated with AKI (adjusted subdistribution hazard ratio, 5.14; 95% CI, 2.11–12.53; P < 0.001). No significant association was observed between treatment regimen and ALT elevation. Conclusions: In patients with CRAB pneumonia, adding colistin to minocycline-based therapy was associated with increased nephrotoxicity without an observed survival difference. These findings highlight nephrotoxicity as an important consideration when selecting colistin-containing regimens for CRAB pneumonia.
