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HIVPhase 2NCT05849038

Inflammation and Depression in People With HIV

A Phase 2 study testing Baricitinib in people with HIV and Depression, run by Emory University at 2 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The purpose of this 10-week, double-blind, placebo-controlled study is to determine whether inflammation impacts reward and motor neural circuitry to contribute to depressive symptoms like anhedonia and psychomotor slowing in people with Human Immunodeficiency Virus (HIV) and depression. Read more about this study

Who is it for?
Ages 18 to 65 years
Conditions the study is for
HIV, Depression, Anhedonia
What is being tested?
Baricitinib
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
60 participants
Where
2 sitesUnited States
Study dates
11 Dec 2023to Nov 2027
Phase
Phase 2
Are there results?
Not yet: the study is under way

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 to 65 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • HIV infected on continuous antiretroviral therapy (ART) with plasma HIV RNA <200 copies/ml for at least 12 months (on at least two previous clinic visits and confirmed at screening)
  • Current cluster of differentiation 4 (CD4+) > 350 cells/microliter for at least twelve months (on at least two previous clinic visits and confirmed at screening)
  • A primary diagnosis of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) major depression, current, or Bipolar, depressed type as diagnosed by the SCID-V
  • Score of ≥10 on the 9-item Patient Health Questionnaire (PHQ-9)
  • Off all antidepressant or other psychotropic therapy (e.g. mood stabilizers, antipsychotics, and sedative hypnotics) for at least 4 weeks (8 weeks for fluoxetine) or on a stable psychotropic regimen for at least 4 weeks prior to baseline visit
  • Significant anhedonia as reflected by a score ≥ 2 on item #1 of the PHQ-9
  • CRP≥2mg/L
  • Women of reproductive age will have a negative serum pregnancy test at study entry and both men and women must agree to adequate contraception while

Who cannot join

  • < 18 years of age or > 65 years of age
  • Pregnancy or breastfeeding
  • Significant hematological abnormalities at screening (ANC < 1500, Hgb<10, platelet< 100,000)
  • History of progressive multifocal leukoencephalopathy
  • Untreated latent tuberculosis infection (which will be screened for prior to entry)
  • Having taken the following immunosuppressive medications within the past 6 months:
Show all 41Show fewer
  • Oral corticosteroids
  • Biologic treatments such as etanercept, infliximab, certolizumab, adalimumab, golimumab, tocilizumab, abatacept, Ustekinumab, ixekizumab, secukinumab, or anakinra
  • Cyclophosphamide (or any other cytotoxic agent), belimumab, or anifrolumab (or another anti-interferon (IFN) therapy)
  • Rituximab, any other B cell depleting therapies, or intravenous immunoglobulin (IVIg)
  • any Janus kinase (JAK) inhibitor
  • 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
  • Stroke history
  • Hematologic malignancies including lymphoma and leukemia
  • Major surgery within 8 weeks prior to screening or will require major surgery during the study
  • Current or recent (<4 weeks prior to randomization) clinically serious viral (including coronavirus disease 2019 (COVID-19)), bacterial, fungal, or parasitic infection or any other active or recent infection
  • Symptomatic herpes simplex at the time of randomization
  • Symptomatic herpes zoster infection within 12 weeks prior to randomization
  • History of disseminated/complicated herpes zoster (for example, ophthalmic zoster or CNS involvement)
  • Positive test for hepatitis B virus (HBV) defined as:
  • positive for hepatitis B surface antigen (HBsAg), or
  • positive for hepatitis B core antibody (HBcAb) and positive for hepatitis B virus deoxyribonucleic acid (HBV DNA)
  • Hepatitis C virus (HCV) infection (hepatitis C antibody-positive and HCV ribonucleic acid [RNA]-positive)
  • Cirrhosis of the liver from any cause
  • Any of the following specific abnormalities on screening laboratory tests:
  • alanine transaminase (ALT) or aspartate aminotransferase (AST) >2 x upper limits of normal (ULN)
  • alkaline phosphatase (ALP) ≥2 x ULN
  • total bilirubin ≥1.5 x ULN (with the exception of patients on atazanavir, who must have total bilirubin <2 x ULN)
  • Chronic kidney disease with estimated glomerular filtration rate (eGFR) <40 mL/min/1.73 m^2
  • History of any (non-mood-related) psychotic disorder; active psychotic symptoms of any type; substance abuse/dependence within 6 months of study entry, as determined by severe combined immunodeficiency (SCID)
  • A positive urine drug screen for illicit drugs at any time during the study excluding marijuana
  • An active suicidal plan as determined by a score >3 on item #3 on the Hamilton Rating Scale for Depression (HAM-D)
  • An active eating disorder or antisocial personality disorder
  • History of dementia
  • Chronic use of glucocorticoid containing medications or minocycline within 2 weeks of baseline or at any time during the study
  • Any contraindication for MRI scanning
  • Failure of more than 2 antidepressant trials (at least 6 weeks at recommended dose) in the current episode or 5 antidepressant trials lifetime
  • BMI >42 (to exclude severe obesity) or at the investigator's discretion based on the patient's ability to fit in the MRI scanner

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Jennifer Felger, PhD contact

404-727-3987

jfelger@emory.edu

United States2 sites, 2 recruiting
  • Grady Memorial Hospital

    Atlanta, Georgia, 30303

    Vincent C Marconi, MD, 404-616-0673, vcmarco@emory.edu

    Recruiting
  • Emory University Hospital

    Atlanta, Georgia, 30322

    Andrew H Miller, MD, (404) 727-8260, amill02@emory.edu

    Recruiting

Other trials in United States

About this study

Official title: The Role of Inflammation in Central Nervous System (CNS) Mechanisms of Anhedonia and Psychomotor Slowing in Depressed People With HIV

The purpose of this 10-week, double-blind, placebo-controlled study is to determine whether inflammation impacts reward and motor neural circuitry to contribute to depressive symptoms like anhedonia and psychomotor slowing in people with Human Immunodeficiency Virus (HIV) and depression. Sixty male and female patients with HIV who have depression, anhedonia and high inflammation and are stable on effective treatment for their HIV will be randomized to receive either the anti-inflammatory drug baricitinib or a placebo for 10 weeks. Participants will complete lab tests, medical and psychiatric assessments, neurocognitive testing, functional MRI (fMRI) scans, and optional spinal taps as part of the study.

Read the detailed description

Risk of depression is substantially higher in people with HIV (PWH) than the general population, and depression in PWH confers worse outcomes regarding treatment adherence, morbidity, and mortality. Increased inflammation is one biological pathway that is linked to greater risk for depression in PWH and limits options for effective antidepressant therapy. Chronically elevated inflammation is associated with impairments within reward and motor neural circuits that contribute to symptoms of anhedonia (an inability to experience pleasure) and psychomotor slowing, which are overrepresented in PWH. The purpose of this 10-week, double-blind, placebo-controlled study is to provide mechanistic information on whether inflammation impacts corticostriatal reward and motor circuitry to contribute to anhedonia and psychomotor slowing in PWH with depression using the anti-inflammatory drug baricitinib.

This study will utilize an FDA-approved medication, baricitinib, to establish whether the effects of inflammation on reward and motor circuits are a mechanism of anhedonia and motor slowing in PWH with depression, while advancing avenues for new therapies.

Sixty male and female patients with HIV who have depression and high inflammation and are stable on effective treatment for their HIV will be randomized to receive either baricitinib or a placebo for 10 weeks. Participants will complete lab tests, medical and psychiatric assessments, neurocognitive testing, functional MRI (fMRI) scans, and optional spinal taps as part of the study.

Being tested
Baricitinib, Placebo
Keywords
Human Immunodeficiency Virus (HIV), Anhedonia, Psychomotor Slowing
Medical subject headings
Depression, Anhedonia, Acquired Immunodeficiency Syndrome, Psychomotor Disorders

What participants receive

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

  • BaricitinibDrug

    Also called Olumiant

    Patients will receive baricitinib at a dose of 2 mg oral daily.

  • PlaceboOther

    A placebo is a sugar pill that has no therapeutic effect and will be administered orally. Participants will receive 1 placebo tablet matching the baricitinib tablet.

Study groups in NCT05849038
Study groupRoleWhat they receive
BaricitinibExperimentalParticipants will be randomized to receive 10 weeks of treatment with baricitinib.
Receives: Drug: Baricitinib
PlaceboPlacebo comparatorParticipants will be randomized to receive 10 weeks of treatment with placebo.
Receives: Other: Placebo

What is being measured

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

  1. Change in corticostriatal functional connectivity (FC) in reward circuit

    Patients will undergo resting-state and task-based functional magnetic resonance imaging (fMRI) to calculate functional connectivity (FC) between the ventral striatum (VS) and ventromedial prefrontal cortex (vmPFC). FC is measured as continuous Z scores reflecting the correlation of activity between the brain regions. Higher FC Z scores reflect stronger connectivity.

    Measured: Baseline visit, week 2, and week 10 after study medication

Secondary outcomes (10)
  1. Change in Effort Expenditure for Reward Task (EEfRT) Score

    The EEfRT is a widely used, multi-trial task measuring motivation for rewards as an assessment of anhedonia, as anhedonia is specifically associated with decreased motivation for rewards. For each task participants repeatedly press a button to raise a "bar" on a screen. Before each task participants choose between between receiving a "hard task" (using the non-dominant little finger) for a larger reward or an "easy task" (using the dominant index finger) for a smaller reward. The EEfRT is reported as the proportion of "hard task" trials that participants select. Possible scores range between 0 to 1 with higher scores indicating greater motivation, which in turn is an indication for lower anhedonia.

    Measured: Baseline visit, week 2, and week 10

  2. Change in Snaith-Hamilton Pleasure Scale-Self Report (SHAPS-SR) Score

    The Snaith-Hamilton Pleasure Scale-Self Report (SHAPS-SR), a 14-item self-report scale with high psychometric validity for assessing the presence of anhedonia, is used to assess hedonic capacity. Participants rate how much they agree or disagree with 14 items phrased as "I would enjoy __" based on their ability to experience pleasure. Of the four possible response categories (Definitely Agree, Agree, Disagree, and Strongly Disagree), either of the disagree responses receives a score of 1 and either of the agree responses receives a score of 0. The total SHAPS-SR score is calculated as the sum of these 14 items and ranges from 0 to 14, where higher SHAPS-SR scores indicate greater anhedonia.

    Measured: Baseline visit, week 1, week 2, week 4, week 6, and week 10

  3. Change in Motivation and Pleasure Scale-Self-Report (MAP-SR) Score

    The Motivation and Pleasure-Self-Report (MAP-SR) is an 18-item self-report inventory that was created to disentangle state-wise motivational and consummatory components of everyday activities over a 24-hour period. Participants respond to statements about daily activities on a 5-point Likert scale from 0 (no pleasure/not at all) to 4 (extreme pleasure/very often). Total scores range from 0 to 72 where higher scores indicate greater motivation and effort given to everyday situations.

    Measured: Baseline visit, week 1, week 2, week 4, week 6, and week 10

  4. Change in Inventory of Depressive Symptoms Self Report (IDS-SR) Anhedonia Subscale Score

    Anhedonia is assessed with a 3-item subscale of the Inventory of Depressive Symptomatology Self-Report (IDS-SR). Items are scored on a 4-point scale from 0 to 3. Total scores for the Anhedonia Subscale range from 0 to 9 with higher scores reflecting greater anhedonia.

    Measured: Baseline visit, week 1, week 2, week 4, week 6, and week 10

  5. Change in Multidimensional Fatigue Inventory (MFI) Score

    The Multidimensional Fatigue Inventory (MFI) assesses 5 dimensions of fatigue, including general fatigue, physical fatigue, mental fatigue, reduced activity and reduced motivation. Participants read 20 statements (such as "I feel very active") and indicate how true that feeling is for them on a 5-point scale where "yes, that is true" = 1 and "no, that is not true" = 5. Total scores range from 20 to 100 and higher scores indicate greater fatigue.

    Measured: Baseline visit, week 1, week 2, week 4, week 6, and week 10

  6. Change in Finger Tapping Task (FTT) Mean Number of Taps

    The Finger Tapping Task (FTT) uses a specially adapted tapper that the participant taps as fast as possible using the index finger. The participant is given 5 consecutive 10-second trials for the preferred and non-preferred hands. The FTT score is calculated as the mean number of taps for the preferred and non-preferred hands. The FTT is designed to assess subtle motor impairment and is altered in subjects with basal ganglia disorders and lesions. A lower score indicates motor impairment.

    Measured: Baseline visit, week 2, and week 10

  7. Change in Finger Tapping Task (FTT) Total Number of Taps

    The Finger Tapping Task (FTT) uses a specially adapted tapper that the participant taps as fast as possible using the index finger. The participant is given 5 consecutive 10-second trials for the preferred and non-preferred hands. The FTT score is calculated as the total number of taps for the preferred and non-preferred hands. The FTT is designed to assess subtle motor impairment and is altered in subjects with basal ganglia disorders and lesions. A lower score indicates motor impairment.

    Measured: Baseline visit, week 2, and week 10

  8. Change in Trail Making Test Part A (TMT-A) Score

    The Trail Making Test Part A (TMT-A) measures psychomotor processing speed by asking participants to accurately draw lines connecting circles printed on a piece of paper as quickly as possible. In Part A, participants connect 25 circles in numeric sequence and the test is scored as the time in seconds that it takes to complete. Higher scores (i.e., time) indicate poorer performance.

    Measured: Baseline visit, week 2, and week 10

  9. Change in Trail Making Test Part B (TMT-B) Score

    The Trail Making Test Part B (TMT-B) measures psychomotor speed, attention, and cognitive sequencing. Participants connect a series of randomly arranged circles in a designated sequential order, based on alternating numbers and letters letters (i.e., 1 to A to 2 to B, etc.) on paper. The test is scored as the time in seconds that it takes to complete. Higher scores (i.e., time) indicate poorer performance.

    Measured: Baseline visit, week 2, and week 10

  10. Change in Digit Symbol Substitution Test (DSST) Score

    The Digit Symbol Substitution Test (DSST) is a test of psychomotor speed, concentration, and graphomotor abilities that asks the respondent to match symbols to numbers as quickly as possible, using a visual reference. The examinee's score is determined by the number of symbols correctly drawn on paper within the 120 second time limit.

    Measured: Baseline visit, week 2, and week 10

Timeline

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

  1. First posted8 May 2023
  2. Study start11 Dec 2023
  3. Primary completionNov 2027 (estimated)
  4. Study completionNov 2027 (estimated)

Resources

More details

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

Study design
Study type
Interventional
Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
60 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05849038
Sponsor's protocol ID
STUDY00005526
Other IDs
5R01MH128872-03, 2025P011788
Status last verified
May 2026
First submitted
27 Apr 2023
Last updated
28 May 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: Individual participant data will be made available for sharing through the National Institute of Mental Health Data Archive (NDA) data sharing platform hosted by the National Institute of Mental Health (NIMH).

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Baricitinib in people with HIV and Depression, run by Emory University at 2 sites 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 8 inclusion and 41 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: looking for participants now, as of the sponsor's last update on 28 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 2 sites 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. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

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

Contact Jennifer Felger, PhD (404-727-3987, jfelger@emory.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in corticostriatal functional connectivity (FC) in reward circuit (time frame: Baseline visit, week 2, and week 10 after study medication). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
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 28 May 2026.

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