Semaglutide Injection Shows Promise in Reducing Liver Fat in People with HIV: NIH-Funded Study
A groundbreaking study funded by the National Institute of Allergy and Infectious Diseases (NIAID) has revealed that a weekly injection of semaglutide can significantly reduce liver fat in individuals with HIV and metabolic dysfunction-associated steatotic liver disease (MASLD). This marks the first clinical trial of semaglutide for MASLD in people with HIV, offering hope for improved treatment options for this population.
MASLD, previously known as nonalcoholic fatty liver disease, is characterized by the accumulation of excess fat in the liver that is not caused by alcohol consumption or viral hepatitis. Over time, this can lead to inflammation, cellular damage, and the development of cardiovascular and liver diseases. MASLD is closely associated with obesity, type 2 diabetes, and other metabolic disorders, making it a prevalent issue in the United States. In fact, it is the leading cause of chronic liver disease and a common reason for liver transplantation.
The study enrolled individuals aged 18 and older who had HIV and MASLD, and whose viral load was suppressed to undetectable levels through antiretroviral therapy (ART). The participants were diverse in terms of ethnicity, race, gender, and age. Semaglutide was self-injected on a weekly basis at increasing doses until reaching a 1 milligram dose at week four. The participants also underwent frequent safety monitoring visits.
After 24 weeks, the study team assessed changes in liver fat content using a specialized MRI technique. The results were astounding, with participants experiencing an average 31% reduction in liver fat. Furthermore, 29% of participants achieved complete resolution of MASLD, meaning their liver fat decreased to 5% or less of overall liver content. The treatment also led to weight loss, reduced fasting blood glucose levels, and reduced fasting triglycerides, all of which are consistent with the effects observed in studies of semaglutide in individuals without HIV.
Another interesting finding from the study was that the volume of the psoas muscle, a large muscle connecting the torso to the lower body, decreased without any significant change in physical function. This suggests that semaglutide may have additional benefits beyond its impact on liver fat.
Overall, semaglutide was well-tolerated by the participants, with only gastrointestinal adverse events reported, such as nausea, diarrhea, vomiting, and abdominal pain. Two participants experienced more significant adverse events possibly related to semaglutide but were still able to continue in the study. Importantly, all participants completed the full 24 weeks of therapy at the prescribed dose.
These findings have significant implications for the treatment of MASLD in people with HIV. Semaglutide has proven to be both safe and effective in reducing liver fat and improving metabolic markers in this population. The study highlights the potential of semaglutide as a therapeutic option for individuals with HIV and MASLD, offering hope for better management of this common and debilitating condition.
Dr. Sarah Read, deputy director of NIAID’s Division of AIDS, expressed her excitement about the study’s findings. She emphasized that this research can inform healthcare decisions for people living with HIV and contribute to a healthier aging process for individuals with HIV over their lifespan. The investigators also mentioned that further research is underway to explore any unique immunologic or inflammatory pathway changes that may occur in people with HIV while taking semaglutide therapy.
The study was presented at the 2024 Conference on Retroviruses and Opportunistic Infections (CROI) in Denver. It was conducted by ACTG, a global clinical trials network focused on HIV and other infectious diseases, in collaboration with NIAID and other NIH institutes. The research was conducted in both the United States and Brazil, with funding contributions from McGovern Medical School at UTHealth Houston.
The groundbreaking results of this study offer hope for individuals with HIV and MASLD, providing a potential new treatment option that can improve liver health and overall well-being. As further research is conducted, semaglutide may become a key component of interdisciplinary care approaches for individuals living with HIV, helping them lead healthier lives and manage the complications associated with metabolic disorders.
