For people with HIV (PWH), semaglutide is effective for metabolic dysfunction-associated steatotic liver disease (MASLD), according to a research letter published online April 30 in the Annals of Internal Medicine.

Jordan E. Lake, M.D., from UTHealth Houston, and colleagues designed a pilot study to examine the effect of semaglutide on magnetic resonance imaging-proton density fat fraction-quantified intrahepatic triglycerides (IHTG) in PWH and MASLD. Eligible participants were aged 18 years or older and had suppressed HIV-1 RNA while using antiretroviral therapy. The per-protocol analysis included 49 of 51 participants with central adiposity, insulin resistance or prediabetes, and steatotic liver disease.

The researchers observed clinically significant reductions in IHTG over 24 weeks. Overall, 29 and 58 percent of participants had complete resolution of MASLD and a relative reduction of IHTG of at least 30 percent, respectively. Anthropometric measurements, glucose regulation markers, and triglyceride concentrations also improved significantly. Semaglutide 1 mg weekly was tolerated by all participants. Grade 1 gastrointestinal symptoms were the most common adverse events.

“In summary, semaglutide, 1 mg weekly, is an effective therapy for MASLD in PWH and shows evidence of broader cardiometabolic benefit,” the authors write.

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