 Chronic pulmonary disease CLD is the most common manifestation of HIVAIDS among children, accounting for more than 50 of HIV-associated mortality. Recently, a novel form of CLD, affecting more than 30 of African HIV-infected older children was described by Ferrand et al in Zimbabwe, high-resolution CT scanning findings showed predominantly small airways disease consistent with constrictive obliterative bronchiolitis OB. . Azithromycin has anti-inflammatory activity and treatment of CLD with this agent may lead to suppression of generalized immune activation. 