Reversing Tissue Fibrosis to Improve Immune Reconstitution in HIV

Exclusion Criteria

• •* Use of any immunomodulator within the 12 months prior to study enrollment. An immunomodulator for the purposes of this study is defined as a drug known to either diminish or augment a patient's immune system. Examples of these include, but are not limited to, systemic corticosteroids (use of topical steroids will be permitted), TNF-inhibitors, rituximab, cyclophosphamide, abatacept,cyclosporine, azathioprine, 6-mercaptopurine, methotrexate, sulfasalazine, cyclosporine, tacrolimus,sirolimus, and intravenous immune globulin.
• •* Current use of an ARB or ACEi.
• •* Current use of rifaximin, fluconazole or lithium given potential for drug interactions with losartan.
• •* Prior reaction or intolerance to an ARB or ACEi.
• •* Prior diagnosis of a chronic inflammatory disease with serologic or clinical evidence as diagnosed by a primary care physician or specialist. Examples of these include, but are not limited to, systemic lupus erythematosus, rheumatoid arthritis, scleroderma, Sjogren's syndrome, mixed connective tissue disease, psoriasis, polymyositis, dermatomyositis, vasculitis, sarcoidosis, Wegener's granulomatosis, giant cell arteritis, polyarteritis nodosa, gastrointestinal pemphigoid, eosinophilic colitis, Crohn's disease, ulcerative colitis, autoimmune hepatitis, and hepatitis C.
• •* Prior diagnosis of a connective tissue disease with genetic, serologic or clinical evidence as diagnosed by a primary care physician or specialist (Marfan's syndrome, Ehlers-Danlos syndrome).
• •* Baseline blood pressure \< 110/70.
• •* Estimated Glomerular Filtration Rate (eGFR) of \< 30ml/min/1.73 m2 within 4 weeks of study initiation or history of advanced renal disease.
• •* AST and/or ALT \> 3 times the upper limit of normal within 4 weeks of study enrollment.
• •* Potassium \> 5.0 within 4 weeks of study enrollment.
• •* Pregnancy.
• •* In women of childbearing age, unwillingness to use birth control for the duration of the study.
• •* Breast feeding.
• •* Prior vaccination with an HPV vaccine, including Cervarix (GlaxoSmithKline) or Gardasil (Merck).
• •* History of hypersensitivity or severe allergic reactions to yeast.
• •HIV-uninfected:
• •* Use of any immunomodulator within the 12 months prior to study enrollment (as defined above).
• •* Current use of an ARB or ACEi.
• •* Prior diagnosis of a chronic inflammatory disease with serologic or clinical evidence (as defined above).
• •* Prior diagnosis of a connective tissue disease with genetic, serologic or clinical evidence as diagnosed by a primary care physician or specialist (Marfan's syndrome, Ehlers-Danlos syndrome).
• •* Pregnancy.