Treatment Research Investigating Depression Effects on Neuroimmune Targets (TRIDENT)

NCT ID: NCT05136703

Last Updated: 2025-07-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

150 participants

Study Classification

INTERVENTIONAL

Study Start Date

2022-08-30

Study Completion Date

2027-07-31

Brief Summary

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The purpose of this randomized controlled trial is to understand how a cognitive-behavioral treatment (a form of psychological treatment) for depression changes the gut microbiome (micro-organisms that regulate the health of the gut), immune system, and the brain functioning in people living with HIV.

Detailed Description

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The overarching goal of this randomized controlled trial (RCT) is to identify the causal pathways that drive depressive symptoms among people with HIV (PWH). The scientific premise is that evidence-based depression treatment is an innovative, experimental probe to determine the neural substrates of depression and mechanistic relevance of microbiome-gut-brain (MGB) axis changes during and after Cognitive-Behavioral Therapy for Adherence and Depression (CBT-AD) on brain and behavioral function.

The proposed causal pathway is that reductions in depressive symptoms following the delivery of CBT-AD treatment will trigger a cascade of alterations in the MGB axis. Specifically, CBT-AD related decreases in depressive symptoms will induce alterations in gut dysbiosis, decrease microbial translocation, and improve soluble neuroactive markers of peripheral immune dysregulation. Our efforts to elucidate the immunologic mechanisms whereby CBT-AD could improve neurobehavioral outcomes will also focus on an established leukocyte signaling pathway, the Conserved Transcriptional Response to Adversity (CTRA), which has been shown to be responsive to behavioral interventions and psychosocial factors outside of HIV.

Conditions

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Depression HIV-1-infection Inflammation

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Investigators Outcome Assessors

Study Groups

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Cognitive-Behavioral Therapy for Adherence and Depression (CBT-AD)

Participants randomized to receive CBT-AD immediately will complete up to 15 individual sessions (12 session with 3 booster sessions) focused on depression and one session of ART Adherence counseling during the four months following randomization.

Group Type EXPERIMENTAL

Cognitive-Behavioral Therapy for Adherence and Depression (CBT-AD)

Intervention Type BEHAVIORAL

CBT-AD is a behavioral intervention administered either in person or via Zoom. Each session lasts approximately 50 minutes. Participants will receive up to 12 individually delivered sessions over 4 months. Participants receive up to three individually delivered booster sessions through 6 months.

Antiretroviral Therapy (ART) Adherence Counseling

Intervention Type BEHAVIORAL

This treatment involves a single session integrating CBT for depression with CBT for adherence following our "Life-Steps" approach.

Wait-List Control (WLC)

Participants randomized to the WLC condition will receive one session of ART adherence counseling immediately following randomization. After six months, WLC participants will have the opportunity to receive 15 individually delivered CBT-AD sessions (12 sessions and 3 booster sessions) focused on depression.

Group Type EXPERIMENTAL

Cognitive-Behavioral Therapy for Adherence and Depression (CBT-AD)

Intervention Type BEHAVIORAL

CBT-AD is a behavioral intervention administered either in person or via Zoom. Each session lasts approximately 50 minutes. Participants will receive up to 12 individually delivered sessions over 4 months. Participants receive up to three individually delivered booster sessions through 6 months.

Antiretroviral Therapy (ART) Adherence Counseling

Intervention Type BEHAVIORAL

This treatment involves a single session integrating CBT for depression with CBT for adherence following our "Life-Steps" approach.

Interventions

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Cognitive-Behavioral Therapy for Adherence and Depression (CBT-AD)

CBT-AD is a behavioral intervention administered either in person or via Zoom. Each session lasts approximately 50 minutes. Participants will receive up to 12 individually delivered sessions over 4 months. Participants receive up to three individually delivered booster sessions through 6 months.

Intervention Type BEHAVIORAL

Antiretroviral Therapy (ART) Adherence Counseling

This treatment involves a single session integrating CBT for depression with CBT for adherence following our "Life-Steps" approach.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

1. Age 18 or older
2. Speaks and reads English
3. Verified HIV+ status with antiretroviral medications bearing his/her name
4. Current diagnosis on Major Depressive Disorder (MDD) using a structured clinical interview (DIAMOND) or Hamilton Rating Scale for Depression scores of 7 or greater
5. If prescribed antidepressants, on a stable regimen and dose for at least 2 months
6. Suppressed HIV viral load (\< 200 copies/mL)
7. Able to complete Functional Magnetic Resonance Imaging (fMRI) scans (i.e., no claustrophobia, no metal implants, no pacemaker, and BMI \< 40)

Exclusion Criteria

1. Unable to provide informed consent
2. Active, untreated major mental illness
3. Pregnancy at baseline
4. Received CBT for depression in the past 2 years
5. 5\. Otherwise eligible but does not complete the run-in period that includes the baseline assessment, biospecimen collection, the fMRI visit, and a separately scheduled randomization visit
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Institute of Mental Health (NIMH)

NIH

Sponsor Role collaborator

Florida International University

OTHER

Sponsor Role lead

Responsible Party

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Adam Carrico, PhD

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Adam W Carrico, PhD

Role: PRINCIPAL_INVESTIGATOR

Florida International University

Locations

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University of Miami Neuroimaging Facility

Coral Gables, Florida, United States

Site Status RECRUITING

Care Resource - Midtown Miami

Miami, Florida, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Adam W Carrico, PhD

Role: CONTACT

(305) 348-7887

Facility Contacts

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Roger McIntosh, PhD

Role: primary

305-243-2047

Adam W Carrico, PhD

Role: primary

(305) 348-7887

Other Identifiers

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R01MH128868

Identifier Type: NIH

Identifier Source: secondary_id

View Link

20210773

Identifier Type: -

Identifier Source: org_study_id

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