Majonga, Edith D.Mapurisa, Gugulethu NewtonRehman, Andrea M.McHugh, GraceBandason, TsitsiMujuru, HildaGonzalez‑Martinez, CarmenOdland, Jon OyvindKennedy, NeilFerrand, Rashida A.2022-08-222022-08-222021-12Majonga, E.D., Mapurisa, G.N., Rehman, A.M. et al. 2021, 'The effect of azithromycin for management of HIV-associated chronic lung disease on right heart function : results from the BREATHE trial', IJC Heart & Vasculature, vol. 37, no. 100920, pp. 1-5, doi : 10.1016/j.ijcha.2021.100920.0167-5273 (print)1874-1754 (online)10.1016/j.ijcha.2021.100920https://repository.up.ac.za/handle/2263/86911BACKGROUND : 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.en© 2021 The Authors. This is an open access article under the CC BY license.ChildrenAdolescentsAfricaRight heartHuman immunodeficiency virus (HIV)Chronic lung disease (CLD)Azithromycin (AZM)HIV-associated chronic lung disease (HCLD)Article