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HivHATIMNCT04451980

The HIV, Adipose Tissue Immunology, and Metabolism Study

An observational study of Hiv and Diabetes Mellitus, Type 2, run by Vanderbilt University Medical Center at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

With the introduction of effective anti-retroviral therapy (ART), HIV-infected persons can now survive for decades, but this success has been accompanied by an increased risk of developing metabolic disease and diabetes in HIV-infected persons compared to the general population. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
Conditions the study is for
Hiv, Diabetes Mellitus, Type 2
What is being tested?
Subcutaneous adipose tissue biopsy, CT scan and Oral glucose tolerance test
How many people
172 participants
Where
1 siteUnited States
Study dates
31 Aug 2017to 1 May 2026
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: HIV-positive participants are recruited from the Vanderbilt Comprehensive Care Clinic, and HIV-negative participants are recruited from Vanderbilt University Medical Center clinics

Who may be able to join

  • On antiretroviral therapy for at least 18 months
  • HIV-1 RNA <400 copies/ml for the prior 12 months
  • CD4+ count >350 cells/µl in the prior 12 months
  • HbA1c in prior 6 months within specified limits (See Figure)
  • Pre-menopausal by self-report or post-menopausal but not on hormone replacement therapy (HRT)
  • A HbA1c >6.5% or a fasting glucose >126mg/dl, or on anti-diabetic medications for at least 6 months
  • Pre-menopausal by self-report or post-menopausal but not on hormone replacement therapy (HRT)

Who cannot join

  • Known inflammatory or rheumatologic conditions
  • Heavy alcohol (>11 drinks per week) or cocaine, amphetamine, or illicit (non-prescribed) opiate abuse by self-report
  • Current use of DPP-4 inhibitors.
  • HIV-negative Participants:
  • Known inflammatory or rheumatologic conditions
  • Heavy alcohol (>11 drinks per week) or cocaine, amphetamine, or illicit (non-prescribed) opiate abuse by self-report
  • Current use of DPP-4 inhibitors.

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Vanderbilt University Medical Center

    Nashville, Tennessee, 37209

Other trials in United States

About this study

With the introduction of effective anti-retroviral therapy (ART), HIV-infected persons can now survive for decades, but this success has been accompanied by an increased risk of developing metabolic disease and diabetes in HIV-infected persons compared to the general population. Recent studies from HIV-negative subjects have identified several associations between circulating immune cell populations and impaired glucose tolerance, including increased activated CD4+ and CD8+ T cells, and reduced regulatory T cells. Of note, these same changes in peripheral T cell subsets are frequently observed in patients with chronic HIV infection. The goal of this study is to assess whether the circulating T cell distribution is reflective of the adipose tissue T cell distribution, and to understand whether chronic adipose tissue T cell activation may impair adipocyte (i.e., fat cell) function and insulin sensitivity. If the investigators' hypotheses are correct, this will demonstrate that chronic peripheral immune activation (i.e., high memory T cells, low naïve cells, and increased expression of activation surface markers) is associated with greater adipose-resident CD4+ and CD8+ T cell expression of activation markers, adipose tissue inflammation, and insulin resistance.

Read the detailed description

With the introduction of effective antiretroviral therapy (ART), HIV-infected persons can now survive for decades, but this success has been accompanied by an increased risk of developing metabolic disease compared HIV-negative persons. In the Multicenter AIDS Cohort Study, HIV-infected men had a greater than 4-fold increased incidence of a new diabetes diagnosis compared to HIV-negative men after adjusting for age and body mass index (BMI). Prevalence studies of diabetes in HIV-infected individuals on ART have reported incidence rates of 3.1 to 14 per 1000 patient-years. Furthermore, treated HIV infection appears to act synergistically with other risk factors, and diabetes prevalence is especially high among HIV-infected individuals with high BMI and advanced age.

Recent studies from HIV-negative subjects identified several associations between adaptive immune cell populations and impaired glucose tolerance. Peripheral T regulatory (Treg) cells are significantly lower in patients with type-2 diabetes , while the numbers activated T cells, CD4+ TH1 (pro-inflammatory) cells, and memory CD4+ T cells are higher in diabetics.

Immune cells translocate from the circulation into adipose tissue in a dynamic process, and T cells are present in the stromal fraction of adipose tissue and affect adipocyte function. The striking increase in adipose tissue CD4+ TH1 cells and CD8+ T cells, and a decrease in Treg cells, observed in obesity may have an important role in the development of insulin resistance. Secretion of the proinflammatory cytokines interferon-γ and interleukin (IL)-17 by TH1 and TH17 cells are implicated in the induction of proinflammatory M1 macrophages, which express IL-6 and tumor necrosis factor alpha, and inhibit adipocyte insulin signaling by promoting phosphorylation of insulin receptor substrate 1. The investigators hypothesize that the chronic, HIV-related activation of circulating CD4+ and CD8+ T cells may be accompanied by the accumulation of activated T cells in adipose tissue with adverse effects on metabolic activity.

In this study, the investigators will test the hypothesis that the oligoclonal expansion of chronically activated peripheral T cells in adipose tissue is a primary driver of macrophage inflammation and reduced adipocyte insulin sensitivity. Furthermore, the investigators propose that this represents a central mechanistic linkage underlying the association between circulating T cell activation and incident diabetes risk observed in HIV-infected and HIV-negative individuals.

Being tested
Subcutaneous adipose tissue biopsy, CT scan, Oral glucose tolerance test, Blood collection
Medical subject headings
Acquired Immunodeficiency Syndrome, Diabetes Mellitus, Type 2

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Subcutaneous adipose tissue biopsyProcedure or surgery

    Percutaneous adipose tissue biopsy

  • CT scanRadiation

    CT scan of chest and abdomen without contrast

  • Oral glucose tolerance testDiagnostic test

    Ingestion of 75g of oral glucose syrup and measurement of blood glucose and insulin at time 0, 15 min, 30 min, 60 min, 90 min, and 120 min.

  • Blood collectionDiagnostic test

    Fasting blood collection for plasma cytokines and T cell phenotypes.

Study groups in NCT04451980
Study groupRoleWhat they receive
HIV+ non-diabeticsHIV-infected participants with hemoglobin A1c (HbA1c) <5.7% or fasting glucose <100 mg/dl.
Receives: Procedure: Subcutaneous adipose tissue biopsy; Radiation: CT scan; Diagnostic Test: Oral glucose tolerance test; Diagnostic Test: Blood collection
HIV+ pre-diabeticsHIV-infected participants with HbA1c 5.7-6.4% or fasting glucose 100-125 mg/dl.
Receives: Procedure: Subcutaneous adipose tissue biopsy; Radiation: CT scan; Diagnostic Test: Oral glucose tolerance test; Diagnostic Test: Blood collection
HIV+ diabeticsHIV-infected participants with HbA1c >=6.5% or fasting glucose >=126 mg/dl or on anti-diabetic medications.
Receives: Procedure: Subcutaneous adipose tissue biopsy; Radiation: CT scan; Diagnostic Test: Blood collection
HIV-negative diabeticsHIV-negative participants with HbA1c >=6.5% or fasting glucose >=126 mg/dl or on anti-diabetic medications.
Receives: Procedure: Subcutaneous adipose tissue biopsy; Radiation: CT scan; Diagnostic Test: Blood collection

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Adipose tissue T cell surface marker phenotype and antigen receptor sequence

    Flow cytometry measurement of adipose tissue T cell surface marker phenotypes and sequencing of T cell receptors, compared by HIV and diabetes status

    Measured: At study enrollment

Secondary outcomes (2)
  1. CT measurements of visceral, hepatic, and pericardial fat content

    Quantification of visceral, hepatic, and pericardial adipose tissue content, compared by HIV and diabetes status

    Measured: At study enrollment

  2. Circulating T cell surface marker phenotype

    Flow cytometry measurement of circulating T cell surface marker phenotypes, compared by HIV and diabetes status

    Measured: At study enrollment

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted30 Jun 2020
  2. Study start31 Aug 2017
  3. Primary completion13 Mar 2020
  4. Study completion1 May 2026

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Cohort
Time perspective
Cross-sectional
Enrolment
172 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04451980
Sponsor's protocol ID
161254
Acronym
HATIM
Status last verified
May 2026
First submitted
16 Jun 2020
Last updated
5 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
Individual data sharing
No: There is no plan to share IPD.

Publications

  • Wanjalla CN, McDonnell WJ, Barnett L, Simmons JD, Furch BD, Lima MC, Woodward BO, Fan R, Fei Y, Baker PG, Ram R, Pilkinton MA, Mashayekhi M, Brown NJ, Mallal SA, Kalams SA, Koethe JR. Adipose Tissue in Persons With HIV Is Enriched for CD4+ T Effector Memory and T Effector Memory RA+ Cells, Which Show Higher CD69 Expression and CD57, CX3CR1, GPR56 Co-expression With Increasing Glucose Intolerance. Front Immunol. 2019 Mar 19;10:408. doi: 10.3389/fimmu.2019.00408. eCollection 2019.

    PubMed 30941121
  • Koethe JR, McDonnell W, Kennedy A, Abana CO, Pilkinton M, Setliff I, Georgiev I, Barnett L, Hager CC, Smith R, Kalams SA, Hasty A, Mallal S. Adipose Tissue is Enriched for Activated and Late-Differentiated CD8+ T Cells and Shows Distinct CD8+ Receptor Usage, Compared With Blood in HIV-Infected Persons. J Acquir Immune Defic Syndr. 2018 Feb 1;77(2):e14-e21. doi: 10.1097/QAI.0000000000001573.

    PubMed 29040163
  • Bailin SS, Ma S, Perry AS, Terry JG, Carr JJ, Nair S, Silver HJ, Shi M, Mashayekhi M, Kropski JA, Ferguson JF, Wanjalla CN, Das SR, Shah R, Koethe JR, Gabriel CL. The Primacy of Adipose Tissue Gene Expression and Plasma Lipidome in Cardiometabolic Disease in Persons With HIV. J Infect Dis. 2025 Feb 20;231(2):e407-e418. doi: 10.1093/infdis/jiae532.

    PubMed 39657693
  • Swartz AZ, Robles ME, Park S, Esfandiari H, Bradshaw M, Koethe JR, Silver HJ. Cardiometabolic Characteristics of Obesity Phenotypes in Persons With HIV. Open Forum Infect Dis. 2024 Jul 8;11(7):ofae376. doi: 10.1093/ofid/ofae376. eCollection 2024 Jul.

    PubMed 39035569
  • Werede AT, Terry JG, Nair S, Temu TM, Shepherd BE, Bailin SS, Mashayekhi M, Gabriel CL, Lima M, Woodward BO, Hannah L, Mallal SA, Beckman JA, Li JZ, Fajnzylber J, Harrison DG, Carr JJ, Koethe JR, Wanjalla CN. Mean Coronary Cross-Sectional Area as a Measure of Arterial Remodeling Using Noncontrast CT Imaging in Persons With HIV. J Am Heart Assoc. 2022 Dec 6;11(23):e025768. doi: 10.1161/JAHA.122.025768. Epub 2022 Nov 16.

    PubMed 36382956

Questions about this trial

What is this clinical trial studying?

An observational study of Hiv and Diabetes Mellitus, Type 2, run by Vanderbilt University Medical Center at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 7 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 5 May 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Adipose tissue T cell surface marker phenotype and antigen receptor sequence (time frame: At study enrollment). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04451980, which also lists 5 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 5 May 2026.

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