Semaglutide effective for patients with HIV and MASLD

More than half of patients with HIV and metabolic dysfunction-associated steatotic liver disease (MASLD) had at least a 30% reduction in intrahepatic triglycerides after 24 weeks on semaglutide, a small uncontrolled study found.

Semaglutide reduced liver fat among patients with HIV and metabolic dysfunction-associated steatotic liver disease (MASLD), a small pilot study found.

The single-group, open-label trial followed 49 patients who had suppressed HIV-1 RNA while using antiretroviral therapy; central adiposity, insulin resistance, or prediabetes; and at least 5% intrahepatic triglycerides. They were given semaglutide, 1 mg weekly, with a primary end point of the 24-week change in intrahepatic triglycerides. The study was published as a research letter by Annals of Internal Medicine on April 30.

At 24 weeks, 29% of participants had complete resolution of MASLD, and 58% had a relative reduction in intrahepatic triglycerides of at least 30%. Significant improvements in anthropometric measurements, glucose regulation markers, and triglyceride concentrations were also observed. All participants tolerated the drug, and the most common adverse events were gastrointestinal symptoms.

"A 30% or greater reduction in [intrahepatic triglycerides] on MRI correlates with improvements in steatohepatitis and fibrosis," said the study authors, who concluded that semaglutide is an effective therapy for MASLD in patients with HIV "and shows evidence of broader cardiometabolic benefit."