Reducing Mortality in Adults With Advanced HIV Disease (REVIVE)

Phase 3

Recruiting

• Conditions: HIV Disease Progression
• Interventions: Drug: Azithromycin Oral Tablet; Drug: Placebo oral tablet

• Registration Number: NCT05580666
• Lead Sponsor: Population Health Research Institute

Brief Summary

A double blinded, placebo-controlled, multicenter trial to evaluate effectiveness of azithromycin prophylaxis on mortality in advanced HIV.

Detailed Description

All participants in the REVIVE trial will be randomized (1:1) at the time of study entry to receive azithromycin prophylaxis or placebo for 28 days and will be followed for 24 weeks to determine the primary outcome measure. Total follow up duration will be 48 weeks.

Study Timeline

• Study First Submitted: 2022-10-11
• Study First Submitted QC: 2022-10-13
• Study First Posted: 2022-10-14
• Study Start: 2023-05-08
• Status Verified: 2025-08
• Last Update Submitted: 2025-08-26
• Last Update Posted: 2025-09-03
• Primary Completion: 2028-11-30
• Study Completion: 2029-05-31

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 8000

Inclusion Criteria

1. Age ≥ 18 years

2. Documented HIV infection

3. CD4 count criteria:

   i. CD4 count ≤ 100 cells/mm3 within past 4 weeks; or

   ii. Documented CD4 nadir ≤ 100 cells/mm3 and complete interruption of ART for ≥ 6 months; or

   iii. Documented CD4 count ≤ 100 cells/mm3 if ART-naive

4. Ability to initiate or re-initiate ART, or switch to an effective ART regimen if failing current therapy, within 4 weeks of enrolment

Exclusion Criteria

1. Contraindications to azithromycin:

   i. Hypersensitivity to azithromycin, erythromycin, or any macrolide antibiotic; or

   ii. Personal or family history of QT-prolongation

2. Severe illness requiring immediate or continued hospitalization (this will be in the judgment of site investigators)

3. Off-label azithromycin prophylaxis or requirement for prolonged (> 7 days) azithromycin (or macrolide) therapy

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: PARALLEL

Arm && Interventions

Group	Intervention	Description
Oral Azithromycin 250 mg once daily	Azithromycin Oral Tablet	Active Azithromycin tablet
Oral matching placebo, once daily	Placebo oral tablet	Matching placebo tablet

Primary Outcome Measures

Name	Time	Method
All-cause mortality	24 weeks after randomization	All-cause mortality over the first 24 weeks after randomization

Secondary Outcome Measures

Name	Time	Method
All-cause mortality	12 weeks after randomization	All-cause mortality over the first 12 weeks after randomization
Hospitalization	24 weeks after randomization	Hospitalization over the first 24 weeks after randomization
Composite of hospitalization or all-cause mortality	24 weeks after randomization	Composite of hospitalization or all-cause mortality over the first 24 weeks after randomization

Trial Locations

Locations (51)

Asella Referral and Teaching Hospital; 🇪🇹 Āsela, Ethiopia

Jimma University Hospital; 🇪🇹 Jimma, Ethiopia

Tigray health research institute (THRI); 🇪🇹 Mek'ele, Ethiopia

Kumasi South Hospital; 🇬🇭 Kumasi, Ghana

Suntreso Government Hospital; 🇬🇭 Kumasi, Ghana

34 Military Hospital; 🇸🇱 Freetown, Sierra Leone

Kenema Regional Hospital; 🇸🇱 Kenema, Sierra Leone

Koidu Government Hospital; 🇸🇱 Koidu, Sierra Leone

Makeni Regional Hospital; 🇸🇱 Makeni, Sierra Leone

Livingstone hospital; 🇿🇦 Port Elizabeth, South Africa

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