This study focuses on people with HIV who experience incomplete immune reconstitution despite suppressive antiretroviral therapy (ART), characterized by persistently low CD4⁺ T cell counts and residual inflammation. The underlying cause is largely attributed to the persistent HIV latent reservoir. Recent evidence indicates that rilpivirine, a non-nucleoside reverse transcriptase inhibitor (NNRTI) commonly used in ART, has an immunomodulatory function beyond its antiviral activity. It activates the CARD8 inflammasome - an intracellular "kill switch" - triggering pyroptosis selectively in HIV-infected cells. In this study, rilpivirine will be added to suppressive ART in patients with incomplete immune reconstitution. The investigators hypothesize that this strategy will reduce the latent reservoir, restore CD4⁺ T cell counts and function, attenuate excessive immune activation, and ultimately improve long-term clinical outcomes.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
21
Participants receive standard combination antiretroviral therapy (cART) plus rilpivirine
Participants receive standard combination antiretroviral therapy (cART) alone
The Fifth Medical Center of PLA General Hospital
Beijing, Beijing Municipality, China
RECRUITING302 Hospital
Beijing, China
RECRUITINGGuangzhou Eighth People's Hospital
Guangzhou, China
RECRUITINGThe Third Affiliated Hospital of Sun Yat-sen University
Guangzhou, China
RECRUITINGShenzhen Third People's Hospital
Shenzhen, China
RECRUITINGCD4⁺ T cell count
Time frame: Baseline to week 36
Number of participants with treatment-emergent adverse events
Safety will be assessed by monitoring and recording all adverse events (AEs), serious adverse events (SAEs), and AEs leading to treatment discontinuation. Adverse events will be graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.
Time frame: From baseline to 36 weekks
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