REVIVE Trial Targets HIV Mortality with Azithromycin

The pan-African study, REVIVE, aims to examine the potential impact of a daily four-week course of azithromycin on mortality rates in adults with advanced HIV. This collaborative effort, funded by the Bill & Melinda Gates Foundation, will be spearheaded by researchers from the University of Cape Town (UCT) and the Population Health Research Institute (PHRI) of Canada.

“The REVIVE trial aims to identify an effective and implementable public health strategy to reduce the unacceptably high early mortality experienced by people with advanced HIV and will establish a pan-African network for future research to improve care for this population,” said Sean Wasserman, Co-principal Investigator (PI), REVIVE. 

Illnesses related to HIV result in approximately 630,000 global deaths annually, with the highest number of fatalities concentrated in sub-Saharan Africa, according to UCT. In 2020, 680,000 people died from HIV related illnesses worldwide. Within this figure, 4,557 people lost their lives in Mexico from the same disease, underscoring the persistent imperative for prevention programs, early detection, and effective HIV treatment.

The study currently has over 330 patients already enrolled and is making strides across the six sites spanning three countries.. It is part of a broader initiative spanning more than 100 locations in Africa, with countries like Botswana, Ethiopia, Ghana, Ivory Coast, Malawi, Nigeria, Republic of the Congo, Rwanda, Sierra Leone, South Africa, Tanzania, Uganda, and Zambia being included, with plans for expansion, as reported by the UCT. “This large clinical trial will contribute important knowledge that we hope will translate into improved care for people with advanced HIV disease,” said Wasserman. 

As HIV remains a critical public health concern worldwide, numerous ongoing initiatives aim to develop treatments that effectively manage the virus and enhance the quality of life for patients. However, significant obstacles lie ahead in this endeavor.

 “We anticipate that new vaccination technologies will grant us tools against seemingly intractable diseases like HIV,” Rodrigo Romero, Coordinator, Mexican Association of Vaccinology told MBN. Despite the existence of over 20 ongoing initiatives for an HIV vaccine, many have not succeeded, including the Mosaico initiative, which ultimately faltered. “The virus itself is the obstacle because it has the ability to change, which renders the antibodies that are created ineffective. That is why this vaccine has not been successful so far, but it is expected that it can be developed in the next 10 years,” he added.

Meanwhile, to prevent the spread and contraction of HIV, individuals must utilize protection during sexual relations and refrain from contact with needles previously used by others, as recommended by Mexico’s Ministry of Health (SSA). Additionally, the SSA advocates for the use of Pre-Exposure Prophylaxis (PrEP), which has been shown to reduce the risk of HIV transmission by over 90%. PrEP is recommended for those who do not consistently use condoms or have HIV-positive sexual partners who are not under viral suppression or use illicit substances.