Baricitinib Curative Repression of HIV-1

Overview

This study is being done to test whether a drug called baricitinib, which blocks specific causes of inflammation, affects HIV-1 viral rebound and viral load levels after HIV treatment is discontinued. Researchers will test the effects of continuing baricitinib in people with HIV before and after discontinuing their antiretroviral therapy. This drug is approved by the Food and Drug Administration (FDA) for other diseases; it is not approved for the treatment of HIV-1. The study team will also investigate any side effects associated with the drug.

Detailed description

This study will test whether the medication baricitinib, which reduces inflammation and is already approved for other diseases, can delay the return of HIV after stopping antiretroviral therapy (ART). The goal is to see if baricitinib can safely reduce inflammation and the HIV that is hidden in the body. The study will include adults with HIV who have a suppressed viral load on ART.

Participants will receive ART combined with baricitinib for 25 weeks, followed by baricitinib alone after stopping ART. If the virus returns, the previous ART will be restarted. Each participant will be involved in the study for approximately 12 to 18 months.

Blood and other biological samples may be stored for future research use, with the participant's consent.

Interventions

• Drug Antiretroviral Therapy (ART)
  Antiretroviral Therapy (ART): A treatment regimen for HIV infection that uses a combination of antiretroviral drugs to suppress viral replication, reduce HIV-related morbidity, and prevent transmission. In Step 1, participants will continue their current ART regimen for 25 weeks. In Step 2, participants will interrupt ART. In Step 3, participants will restart ART early if they meet the ART restart criteria before the end of Step 2 (a 25-week maximum). Otherwise, they will resume ART at the en
• Drug Baricitinib (LY3009104) 2 mg
  Baricitinib is an orally administered, selective inhibitor of Janus kinase (JAK) 1 and 2. It reduces cytokine-mediated signaling involved in inflammation and immune activation. Baricitinib is FDA-approved for rheumatoid arthritis (RA), atopic dermatitis, and alopecia areata. It has also been authorized for the treatment of COVID-19 in hospitalized patients. During Step 1, Baricitinib will be taken at a dose of 2 mg orally daily for 25 weeks. During Step 2, Baricitinib alone will be continued a
• Drug Baricitinib (LY3009104) 4 mg
  Baricitinib is an orally administered, selective inhibitor of Janus kinase (JAK) 1 and 2. It reduces cytokine-mediated signaling involved in inflammation and immune activation. Baricitinib is FDA-approved for rheumatoid arthritis (RA), atopic dermatitis, and alopecia areata. It has also been authorized for the treatment of COVID-19 in hospitalized patients. During Step 1, Baricitinib will be taken at a dose of 4 mg orally daily for 25 weeks. During Step 2, Baricitinib alone will be continued a

Primary outcome measures

• Time to restart ART [Time frame: Up to 25 weeks after the baricitinib treatment alone was started]
• Number of Participants who discontinued treatment due to adverse events [Time frame: Up to 25 weeks after the start of baricitinib alone was started]
• Incidence of Adverse Events (AEs) and Serious Adverse Events (SAEs) [Time frame: Up to 25 weeks after the start of baricitinib alone was started]

Secondary outcome measures (1)

• Time to a detectable plasma HIV-1 RNA viral load [Time frame: Up to 25 weeks after baricitinib alone was started.]

Eligibility criteria

Inclusion criteria

• Documented HIV infection
• On continuous ART for at least 96 weeks before enrollment, with no interruption of ART for 7 consecutive days or longer in the 48 weeks before enrollment.
• Plasma HIV-1 RNA levels of <50 copies/mL for at least 96 weeks (a minimum of two measures), and <50 copies/mL for a sample obtained within 90 days, before enrollment.
• CD4+ T-cell count ≥500 cells/mm3 obtained within 90 days prior to enrollment
• No known history of CD4+ T-cell count nadir <200 cells/mm3
• Negative pregnancy test at time of study enrollment
• Additional laboratory criteria may apply.

Exclusion criteria

• < 18 years of age or > 70 years of age
• Pregnancy or breastfeeding, as determined by a blood pregnancy test
• History of AIDS-defining illness, except for recurrent pneumonia.
• History of progressive multifocal leukoencephalopathy or clinically significant HIV-associated neurocognitive disease.
• Untreated latent tuberculosis infection (which will be screened for before entry). If there is a prior positive test, the test does not need to be repeated at screening.
• History of use of any immunomodulatory medications within 6 months before enrollment, including systemic corticosteroids (>14 days), immunosuppressants, anti-cancer, interleukins, systemic interferons, systemic chemotherapy, or other medications that the site investigator feels could have an immunomodulatory effect.
• History of deep venous thrombosis
• Cardiovascular disease (Coronary artery disease or history of myocardial infarction, Congestive heart failure with left ventricular ejection fraction ≤40% per American Heart Association guidelines, history of stroke)
• History of HIV-associated malignancy, including Kaposi's sarcoma, or any lymphoma/leukemia or virus-associated cancers. Active or recent non-HIV-associated malignancy requiring systemic chemotherapy or surgery in the preceding 36 months
• Major surgery within 8 weeks before screening, or will require major surgery during the study
• Current or recent (<4 weeks before screening) clinically serious viral (including COVID-19), bacterial, fungal, or parasitic infection or any other active or recent infection. History of untreated syphilis infection. If a rapid plasma reagin (RPR) test was negative in the 3 months before screening, then an RPR is not needed at screening
• Symptomatic herpes simplex at the time of screening.
• Symptomatic herpes zoster infection within 12 weeks before screening.
• History of disseminated/complicated herpes zoster (for example, ophthalmic zoster or central nervous system (CNS) involvement).
• Positive test for hepatitis B virus (HBV)
• Additional exclusion criteria apply

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Non-randomized

Model

Sequential

Masking

Open label

Primary purpose

Treatment

Study locations

United States · 2 centers

• Grady Infectious Diseases Clinic (Ponce Center) — Atlanta
• Dr. Gavegnano's Laboratory — Atlanta

Identifiers

NCT: NCT07209267 · STUDY00009759 · 2025P012728

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗