REVIVE is an international multicenter study evaluating azithromycin prophylaxis to reduce mortality in people living with advanced HIV disease and a CD4 count of 100 cells/mm3 or less (Website: https://www.phri.ca/research/revive/). The study, which began in 2023, aims to enroll 8,000 participants in over 150 centers, including Asella, Ethiopia. 

Azithromycin, administered for 4 weeks in combination with antiretroviral therapy, will be compared with a corresponding placebo and administered against the background of standard treatment for advanced HIV disease in accordance with relevant local guidelines.

The primary outcome is overall mortality 24 weeks after randomization, and the secondary outcomes are overall mortality after 12 weeks, hospitalization after 24 weeks, and the composite of hospitalization and overall mortality after 24 weeks. Additional outcomes of interest are being investigated in substudies, including cause of death and transmission of antimicrobial-resistant pathogens, as well as the cost-effectiveness of azithromycin.