HIV Infections Clinical Trial
Official title:
Impact of Co-Receptor and HIV Viral Burden on Gut Mucosa
The lining of the gastrointestinal tract contains specialized lymphoid tissue that is part of the immune system. Like other parts of the immune system, HIV attacks this lymphoid tissue. This study will evaluate the effect of an anti-inflammatory drug on the lymphoid tissue in the gastrointestinal tracts of people with HIV.
The gastrointestinal tract is the body’s largest lymphoid organ. Because it contains
significant numbers of activated memory T lymphocytes, it is a prime site for HIV infection
and amplification. Mucosal T cells are extremely vulnerable to HIV infection due, in part,
to a marked increase in CCR5 co-receptors. Understanding the impact of HIV on the
gastrointestinal-associated lymphoid tissue (GALT) is essential and may provide insight into
the profound drop in mucosal lymphocytes during early infection, persistence of tissue viral
replication in the setting of undetectable plasma viral activity, and compartmentalization
of HIV.
Pre-clinical studies have demonstrated that the mucosal compartment in HIV uninfected
individuals is characterized by features which enhance vulnerability to HIV infection
compared to blood. Once infected, the mucosal response to HIV is inflammation. This study
will further evaluate the inflammatory response of mucosal tissue to HIV by examining the
effect of the anti-inflammatory drug 5-aminosalicylic acid (5-ASA) on the gut mucosa.
Participants in this study will be randomly assigned to receive either 5-ASA or placebo.
Participants will be enrolled in the study for 8 weeks; participants may then elect to
continue on 5-ASA for an additional 16 weeks. Participants will have four screening visits
in the month prior to beginning the study and four study visits during the 8-week study.
Assessments will include medical interviews and physical exams, sigmoidoscopy with mucosal
biopsy, and blood tests.
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Allocation: Randomized, Endpoint Classification: Safety Study, Intervention Model: Factorial Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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