Clinical Trials

Inclusion Criteria

• HIV infection (verified by previous positive antibody or detectable HIV RNA level)
• Age > 50 years
• Receiving continuous ART for ≥ 2 years (regimen changes > 6 months prior to enrollment are allowed)
• HIV RNA level < 200 copies/mL for ≥ 1 year (1 measure ≥ 200 allowed if also < 1000 and preceded and followed by values < 200 copies/mL)
• Blood CD4+ T-cell count < 600 cells/mm cubed
• Systolic blood pressure > 120 mmHg (mean value if ≥ 2 measures obtained)
• Estimated glomerular filtration rate (GFR) > 30 mL/min/1.73 m squared
• Do not anticipate starting or stopping statin or aspirin therapy during the study

Exclusion Criteria

• Pregnancy or breastfeeding
• A contraindication to taking an angiotensin receptor blocker (ARB) (e.g., cirrhosis, prior angioedema with angiotensin-converting enzyme inhibitor (ACE-I), or use of drug with potential drug-interaction [e.g., rifaximin])
• A clinical indication for ARB or ACE-I therapy
• Current treatment with ARB or medication with overlapping mechanism (e.g., ACE-I or aldosterone antagonist)
• Current treatment with immunomodulatory drugs within the past 6 months
• Current hepatitis treatments (e.g., interferon, ribavirin) within the past 6 months
• Serum potassium > 5.0 millimoles per liter (mmol/L) within 3 months of entry
• Invasive cancer in the prior year or receiving cancer treatment (not including carcinoma-in-situ or basal cell cancer of the skin)
• Cirrhosis or end-stage liver disease
• Rheumatologic or chronic inflammatory disease (e.g., systematic lupus erythematous, psoriasis, rheumatoid arthritis, vasculitis, sarcoidosis, Crohn's disease)