Targeted Anticoagulation Therapy to Reduce Inflammation and Cellular Activation in Long-term HIV Disease

Inclusion Criteria * HIV infection (verified by previous positive antibody or detectable HIV RNA level) * Age ≥18 years * Receiving continuous ART for ≥2 years (regimen changes \>3 months prior to enrollment are acceptable) * HIV RNA level ≤200 copies/mL for ≥1 year (1 measure ≥200 allowed if also \<500 and preceded and followed by one or more values ≤200 copies/mL) * D-dimer level ≥100 mg/L (or ng/mL) at screening (or within the prior month) * Estimated creatinine clearance ≥50 mL/min * Body weight ≥60kg * Do not anticipate starting (or stopping) statin or aspirin therapy during the study * For women of child bearing potential, agrees to use a reliable form of birth control Exclusion Criteria * Pregnancy or breast feeding * A contra-indication to taking edoxaban * A clinical indication for anticoagulation therapy (e.g., atrial fibrillation or Deep Vein Thrombosis/PE) * Treatment with anti-platelet, anti-coagulation, or immune-modulatory drugs currently or within the past 6 months; prior self-limited treatment with aspirin (i.e., not daily use) is not itself an exclusion. * Grade ≥1 hematology lab abnormality for INR (\>1.1 x ULN), hemoglobin (\<10.0 g/L), platelets (\<100,000 cells/μL), and WBC (2,500 cells/mm3) * Grade ≥2 lab abnormality for chemistries (BMP) or liver panel * Alcohol or illicit drug abuse/dependency within the prior year * History of prior myocardial infarction or unstable atherosclerotic disease * History of prior stroke or transient ischemic attack (TIA) * History of active gastrointestinal ulcer or bleeding disorder within the prior year * Intent to have surgery during the study period (12 months) * Hepatitis C treatments (e.g., interferon, ribavirin, protease inhibitors) within the past 6 months * Cirrhosis or hepatic impairment (e.g., Child-Pugh class B or C). * Seizure disorder * Previous/current CNS space occupying lesion (e.g., Toxoplasmosis, mTB) with persistent abnormalities on CNS imaging after completion of treatment. * Surgical or invasive procedure anticipated during study period. * Invasive cancer in the prior year or receiving cancer treatment (not including carcinoma-in-situ or basal cell cancer of the skin) * Rheumatologic or inflammatory disease, systemic in nature (e.g., systemic lupus erythematosus, rheumatoid arthritis, vasculitis, sarcoidosis, Crohn's disease) * Assessment by the clinical investigator that enrollment into the study could entail excess risk to the participant, beyond what is intended or expected.