Effect of azithromycin on incidence of acute respiratory exacerbations in children with HIV taking antiretroviral therapy and co-morbid chronic lung disease: a secondary analysis of the BREATHE trial.
Journal
EClinicalMedicine
ISSN: 2589-5370
Titre abrégé: EClinicalMedicine
Pays: England
ID NLM: 101733727
Informations de publication
Date de publication:
Dec 2021
Dec 2021
Historique:
received:
22
06
2021
revised:
23
10
2021
accepted:
25
10
2021
entrez:
25
11
2021
pubmed:
26
11
2021
medline:
26
11
2021
Statut:
epublish
Résumé
In the BREATHE trial weekly azithromycin decreased the rate of acute respiratory exacerbations (AREs) compared to placebo among children and adolescents with HIV-associated chronic lung disease (CLD) taking antiretroviral therapy (ART). The aim of this analysis was to identify risk factors associated with AREs and mediators of the effect of azithromycin on AREs. The primary outcome of this analysis was the rate of AREs by study arm up to 49 weeks. We analysed rates using Poisson regression with random intercepts. Interaction terms were fitted for potential effect modifiers. Participants were recruited from Zimbabwe and Malawi between15 June 2016 and 4 September 2018. We analysed data from 345 participants (171 allocated to azithromycin and 174 allocated to placebo). Rates of AREs were higher among those with an abnormally high respiratory rate at baseline (adjusted rate ratio (aRR) 2.08 95% CI 1.10-3.95 p-value 0.02) and among those with a CD4 cell count <200 cells/mm These may represent subgroups who may benefit the most from treatment with weekly azithromycin, which could help guide targeted treatment. There was no funding source for this post hoc analysis.
Sections du résumé
BACKGROUND
BACKGROUND
In the BREATHE trial weekly azithromycin decreased the rate of acute respiratory exacerbations (AREs) compared to placebo among children and adolescents with HIV-associated chronic lung disease (CLD) taking antiretroviral therapy (ART). The aim of this analysis was to identify risk factors associated with AREs and mediators of the effect of azithromycin on AREs.
METHODS
METHODS
The primary outcome of this analysis was the rate of AREs by study arm up to 49 weeks. We analysed rates using Poisson regression with random intercepts. Interaction terms were fitted for potential effect modifiers. Participants were recruited from Zimbabwe and Malawi between15 June 2016 and 4 September 2018.
FINDINGS
RESULTS
We analysed data from 345 participants (171 allocated to azithromycin and 174 allocated to placebo). Rates of AREs were higher among those with an abnormally high respiratory rate at baseline (adjusted rate ratio (aRR) 2.08 95% CI 1.10-3.95 p-value 0.02) and among those with a CD4 cell count <200 cells/mm
INTERPRETATION
CONCLUSIONS
These may represent subgroups who may benefit the most from treatment with weekly azithromycin, which could help guide targeted treatment.
FUNDING
BACKGROUND
There was no funding source for this post hoc analysis.
Identifiants
pubmed: 34820609
doi: 10.1016/j.eclinm.2021.101195
pii: S2589-5370(21)00476-4
pmc: PMC8599092
doi:
Types de publication
Journal Article
Langues
eng
Pagination
101195Subventions
Organisme : Medical Research Council
ID : MR/R010161/1
Pays : United Kingdom
Informations de copyright
© 2021 The Author(s).
Déclaration de conflit d'intérêts
Dr Ferrand is funded by the Wellcome Trust. Drs Rehman, and Simms are partly funded by grant MR/R010161/1 from the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement. The remaining authors declare no conflict of interest.
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