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Phase 2 N=52 Randomized Triple-blind Treatment

Reversing Tissue Fibrosis to Improve Immune Reconstitution in HIV

HIV Infection · HIV Infections

Enrolled (actual)
52
Serious AEs
15.4%
Results posted
Dec 2020
Primary outcome: Primary: Collagen Deposition in LT — 34.866; 31.02; 30.8925; 29.4492 percent area

Study Design & Population

Study type
Interventional
Phase
Phase 2
Interventions
Losartan (Drug); Placebo (Drug)
Age
Adult, Older Adult · 18+ yrs
Sex
All
Sponsor
University of Minnesota
Primary completion
Jul 2019

Outcome Measures

OutcomeResultp-value
PRIMARY
Collagen Deposition in LT
34.866; 31.02; 30.8925; 29.4492
PRIMARY
Integrity of the Fibroblastic Reticular Cell Network (FRCn)
SECONDARY
Frequency of CD4+ T Cells
SECONDARY
Frequency TUNEL+CD3+CD8+ T Cells
SECONDARY
Frequency of Cells Expressing TGF-beta and Lymphotoxin-beta
SECONDARY
Serum Concentration of IL-7
SECONDARY
Serum Concentration of TGF-beta
SECONDARY
Immune Response to HPV Vaccination
SECONDARY
Frequency of Activated T-cell Populations - Immunofluorescent Staining
SECONDARY
Percent of Activated T Cells in PBMCs - Flow Cytometry
SECONDARY
Percent of Activated Macrophages in PBMCs - Flow Cytometry
SECONDARY
Percent of Activated Dendritic Cells in PBMCs - Flow Cytometry
SECONDARY
Percent of Activated T Cells in LT - Flow Cytometry
SECONDARY
Percent of Activated Macrophages in LT - Flow Cytometry
SECONDARY
Percent of Activated Dendritic Cells in LT - Flow Cytometry
SECONDARY
Intracellular Concentration of IL-17 in PBMCs
SECONDARY
Intracellular Concentration of IFNg in PBMCs
SECONDARY
Intracellular Concentration of IL-2 in PBMCs
SECONDARY
Intracellular Concentration of TNF in PBMCs
SECONDARY
Intracellular Concentration of IL-10 in PBMCs
SECONDARY
Intracellular Concentration of GM-CSF in PBMCs
SECONDARY
Intracellular Concentration of IL-17 in LT
SECONDARY
Intracellular Concentration of IFNg in LT
SECONDARY
Intracellular Concentration of IL-2 in LT
SECONDARY
Intracellular Concentration of TNF in LT
SECONDARY
Intracellular Concentration of IL-10 in LT
SECONDARY
Intracellular Concentration of GM-CSF in LT
SECONDARY
Plasma Concentration of LPS
SECONDARY
Plasma Concentration of sCD14
SECONDARY
Plasma Concentration of I-FABP
SECONDARY
Plasma Concentration of IL-1b
SECONDARY
Plasma Concentration of IL-1RA
SECONDARY
Plasma Concentration of IL-6
SECONDARY
Plasma Concentration of TNF
SECONDARY
Plasma Concentration of Amyloid A
SECONDARY
Plasma Concentration of CRP
SECONDARY
Plasma Concentration of D-dimer
SECONDARY
Frequency of HIV RNA+ and DNA+ Cells in LN - Radiolabeled ISH
SECONDARY
Frequency of HIV RNA+ and DNA+ Cells in LN - RNAscopeTM in Situ Technology
SECONDARY
Frequency of HIV RNA+ and DNA+ Cells in GALT - Radiolabeled in Situ Hybridization (ISH)
SECONDARY
Frequency of HIV RNA+ and DNA+ Cells in GALT - RNAscopeTM in Situ Technology
SECONDARY
Concentration of Losartan and Antiretrovirals (ARVs)
SECONDARY
Intracellular Concentration of Losartan and Antiretrovirals (ARVs)

Summary

This study was designed to test the hypothesis that treatment of HIV infected subjects with losartan, an agent with specific anti-inflammatory and anti-fibrotic actions, will: 1. reverse existing lymphoid tissue fibrosis, 2. restore lymphoid tissue architecture, 3. increase the number and improve the function of peripheral and lymphatic CD4 T cells, 4. decrease levels of systemic immune activation (IA), 5. decrease size of the HIV reservoir, and 6. be safe and well tolerated.

Eligibility Criteria

HIV infected participants:

  • Inclusion Criteria:

Participants must meet all of the following inclusion criteria to participate in this study:

  • HIV-1 infected.

-≥ 18 years of age.

  • Baseline peripheral CD4+ T cell count 200-600 cells/mm3 for at least two measures over the 6 months prior to study enrollment.

-≥ 12 months of stable ART, defined as use of a given drug regimen without disruption lasting ≥ 1 week in the period leading up to study enrollment.

  • HIV viral load (VL) 3 times the upper limit of normal within 4 weeks of study enrollment.
  • Potassium > 5.0 within 4 weeks of study enrollment.
  • Pregnancy.
  • In women of childbearing age, unwillingness to use birth control for the duration of the study.
  • Breast feeding.
  • Prior vaccination with an HPV vaccine, including Cervarix (GlaxoSmithKline) or Gardasil (Merck).
  • History of hypersensitivity or severe allergic reactions to yeast.

HIV-uninfected:

  • Inclusion Criteria

Participants must meet all of the following inclusion criteria to participate in this study:

  • HIV uninfected.

-≥ 18 years of age.

  • No contraindication to proposed study procedures.
  • Exclusion Criteria: Participants meeting any of the following exclusion criteria at baseline will be excluded from study participation:
  • Use of any immunomodulator within the 12 months prior to study enrollment (as defined above).
  • Current use of an ARB or ACEi.
  • Prior diagnosis of a chronic inflammatory disease with serologic or clinical evidence (as defined above).
  • Prior diagnosis of a connective tissue disease with genetic, serologic or clinical evidence as diagnosed by a primary care physician or specialist (Marfan's syndrome, Ehlers-Danlos syndrome).
  • Pregnancy.
View full record on ClinicalTrials.gov →

Data sourced from ClinicalTrials.gov (NCT01852942). Outcome figures and adverse-event rates are extracted automatically from the registry's posted results and are provided for clinician reference, not as a substitute for the primary publication.

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