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Author Notes:

Vincent C. Marconi, Division of Infectious Disease, Emory University School of Medicine, 1760 Haygood Dr NE, Suite 300, Office: 404-727-2343, Fax:404-712-4193. Email: vcmarco@emory.edu

BKT, MT, EWF, VCM - Original manuscript drafting and editing, study conception and design BKT, MT, RFS, CCM, TP, CG RFS - Data collection, data analysis, manuscript editing KM, CK, TH, NGL, RFS - Data collection, manuscript editing BKT and MT - contributed equally to this work

We are grateful to the participants, clinical staff, and study team members for their generous contributions to this work.

V.C.M. has received investigator-initiated research grants (to the institution) and consultation fees (both unrelated to the current work) from Eli Lilly, Bayer, Gilead Sciences and ViiV. All other authors report no potential conflicts.


Research Funding:

Research reported in this publication was supported by the Emory Medical Care Foundation and the Emory Center for AIDS Research (P30AI050409). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Immunology
  • Infectious Diseases
  • immune nonresponders
  • mindfulness
  • CBCT
  • inflammation
  • HIV

Cognitively Based Compassion Training for HIV Immune Nonresponders-An Attention-Placebo Randomized Controlled Trial

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Journal Title:



Volume 89, Number 3


, Pages 340-348

Type of Work:

Article | Post-print: After Peer Review


Objective: Chronic inflammation is associated with increased morbidity and mortality for people with HIV (PWH). Psychological stress is an important contributor to this chronic inflammation. We hypothesized that a cognitively based compassion training (CBCT) approach could reduce inflammation and psychological stress in immune nonresponder PWH. Design: An attention-placebo randomized controlled trial design to evaluate the acceptability of CBCT among PWH and its effects on key aspects of stress and immune function compared with an active-attention control group (NCT02395289). Methods: This study was conducted at an HIV clinic in Atlanta, Georgia. Eligible individuals determined by (1) adherence to antiretroviral therapy for at least a year, (2) virologic suppression; and (3) stable CD4+T-cell counts <350 cells/L were randomized in a 2:1 ratio to either CBCT or control in 2 study periods: April-May, 2016, and September-December, 2016. Psychological measures and inflammatory biomarkers associated with HIV disease progression (IL-1β, TNF-α, sCD14, IL-6, and IL-10) were obtained for all study participants at baseline and at the time of study completion. Results: We found a significant association between CBCT practice time engagement and fold reduction in IL-6 and TNF-α levels. There was no association between CBCT practice time and other biomarkers markers assessed (IL-1β, sCD14, and IL-10). These changes were coincident with significant increases in self-reported psychological well-being and HIV disease acceptance and in benefits for CBCT participants. We also observed fewer instances of virologic failure for those in the CBCT arm compared with controls. Conclusions: CBCT is a novel and feasible nonmedication-based intervention that could reduce inflammation and psychological stress in PWH.

Copyright information:

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (https://creativecommons.org/licenses/by-nc/4.0/).
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