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The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function: Results from the BREATHE trial
BACKGROUND: Right heart abnormalities and pulmonary hypertension (PH) may be secondary to chronic lung disease. Chronic lung disease is common in children with HIV. In the BREATHE trial (Trial registration: NCT02426112), azithromycin (AZM) reduced the risk of acute respiratory exacerbations in child...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609135/ https://www.ncbi.nlm.nih.gov/pubmed/34849393 http://dx.doi.org/10.1016/j.ijcha.2021.100920 |
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author | Majonga, Edith D. Mapurisa, Gugulethu Newton Rehman, Andrea M. McHugh, Grace Bandason, Tsitsi Mujuru, Hilda Gonzalez-Martinez, Carmen Odland, Jon O. Kennedy, Neil Ferrand, Rashida A. |
author_facet | Majonga, Edith D. Mapurisa, Gugulethu Newton Rehman, Andrea M. McHugh, Grace Bandason, Tsitsi Mujuru, Hilda Gonzalez-Martinez, Carmen Odland, Jon O. Kennedy, Neil Ferrand, Rashida A. |
author_sort | Majonga, Edith D. |
collection | PubMed |
description | BACKGROUND: Right heart abnormalities and pulmonary hypertension (PH) may be secondary to chronic lung disease. Chronic lung disease is common in children with HIV. In the BREATHE trial (Trial registration: NCT02426112), azithromycin (AZM) reduced the risk of acute respiratory exacerbations in children aged 6–19 years with HIV-associated chronic lung disease (HCLD) taking antiretroviral therapy. We assessed the possible effect of AZM on right heart dysfunction and/or PH in the trial. METHODS: A standardised transthoracic echocardiogram using M-mode, two-dimensional and Doppler was performed, at baseline and at completion of weight-based AZM given weekly for 48 weeks. Linear regression was used to compare trial arms. RESULTS: A total of 169 participants (82 AZM arm; 87 placebo arm) were included. Participants in the placebo arm were older, median age 16.2 (13.0–18.2) vs 15.3 (12.9–17.4) years, p = 0.184 in the AZM arm. At baseline, right heart abnormalities (right ventricular systolic dysfunction (RVSD), dilatation, or PH) were observed in 7(4%). Following treatment, there was no difference in prevalence of RVSD between arms (p = 0.761). There was one incident case of suspected PH, and overall, no difference in pulmonary pressures. CONCLUSION: In children with HCLD, there was evidence of secondary cardiac effects, but AZM had no effect on right heart function. Long-term follow-up in children with HIV should be part of future research to understand the clinical implications of right heart abnormalities. |
format | Online Article Text |
id | pubmed-8609135 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-86091352021-11-29 The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function: Results from the BREATHE trial Majonga, Edith D. Mapurisa, Gugulethu Newton Rehman, Andrea M. McHugh, Grace Bandason, Tsitsi Mujuru, Hilda Gonzalez-Martinez, Carmen Odland, Jon O. Kennedy, Neil Ferrand, Rashida A. Int J Cardiol Heart Vasc Original Paper BACKGROUND: Right heart abnormalities and pulmonary hypertension (PH) may be secondary to chronic lung disease. Chronic lung disease is common in children with HIV. In the BREATHE trial (Trial registration: NCT02426112), azithromycin (AZM) reduced the risk of acute respiratory exacerbations in children aged 6–19 years with HIV-associated chronic lung disease (HCLD) taking antiretroviral therapy. We assessed the possible effect of AZM on right heart dysfunction and/or PH in the trial. METHODS: A standardised transthoracic echocardiogram using M-mode, two-dimensional and Doppler was performed, at baseline and at completion of weight-based AZM given weekly for 48 weeks. Linear regression was used to compare trial arms. RESULTS: A total of 169 participants (82 AZM arm; 87 placebo arm) were included. Participants in the placebo arm were older, median age 16.2 (13.0–18.2) vs 15.3 (12.9–17.4) years, p = 0.184 in the AZM arm. At baseline, right heart abnormalities (right ventricular systolic dysfunction (RVSD), dilatation, or PH) were observed in 7(4%). Following treatment, there was no difference in prevalence of RVSD between arms (p = 0.761). There was one incident case of suspected PH, and overall, no difference in pulmonary pressures. CONCLUSION: In children with HCLD, there was evidence of secondary cardiac effects, but AZM had no effect on right heart function. Long-term follow-up in children with HIV should be part of future research to understand the clinical implications of right heart abnormalities. Elsevier 2021-11-20 /pmc/articles/PMC8609135/ /pubmed/34849393 http://dx.doi.org/10.1016/j.ijcha.2021.100920 Text en © 2021 The Authors. Published by Elsevier B.V. https://creativecommons.org/licenses/by/4.0/This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Original Paper Majonga, Edith D. Mapurisa, Gugulethu Newton Rehman, Andrea M. McHugh, Grace Bandason, Tsitsi Mujuru, Hilda Gonzalez-Martinez, Carmen Odland, Jon O. Kennedy, Neil Ferrand, Rashida A. The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function: Results from the BREATHE trial |
title | The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function: Results from the BREATHE trial |
title_full | The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function: Results from the BREATHE trial |
title_fullStr | The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function: Results from the BREATHE trial |
title_full_unstemmed | The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function: Results from the BREATHE trial |
title_short | The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function: Results from the BREATHE trial |
title_sort | effect of azithromycin for management of hiv-associated chronic lung disease on right heart function: results from the breathe trial |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8609135/ https://www.ncbi.nlm.nih.gov/pubmed/34849393 http://dx.doi.org/10.1016/j.ijcha.2021.100920 |
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