A Pilot Study of Metformin to Reduce Cerebrovascular Dysfunction in Participants With HIV and Metabolic Syndrome.

Prior treatment

• Treated with metformin as part of care;
• History of drug or alcohol abuse within 3 months before screening;
• Cationic drugs (as listed in the metformin package insert) that may increase metformin concentrations significantly;

Other illness

• Known neuropsychiatric disorders or serious psychiatric symptoms;
• Renal impairment (estimated glomerular filtration \< 60 mL/min/1.73m2);
• Hypersensitivity to metformin;
• Claustrophobia, metal implants or any other condition that prevents performing MR scan;

Lab values

• Type I or type II diabetes (fasting plasma glucose \>7mmol/L and/or HbA1c \>6.5%);

Other

• Known neurosyphilis;
• Known vitamin B12 deficiency;
• Significant head trauma with imaging structural abnormalities;
• Any contraindication or special precaution in the metformin package insert which may put the participant at a safety risk;
• Pregnant / breastfeeding;

• Adult (\>18 years);
• HIV+ on antiretroviral therapy for at least 12 months prior to study entry;
• Viral load ≤50 copies/mL;
• Able to provide informed consent;
• Metabolic syndrome as per the harmonized criteria;
• Women of child-bearing potential willing to use adequate contraception (defined as either an intra-uterine contraceptive device or hormonal contraceptive);