The provided source explores the increasing use of GLP-1 receptor agonists like semaglutide and liraglutide in individuals with HIV. It highlights that these medications are beneficial for addressing obesity and metabolic syndrome, common issues exacerbated by antiretroviral therapy, by promoting weight loss, especially visceral fat, and improving glycemic control. Furthermore, the text explains their potential in managing lipodystrophy and nonalcoholic fatty liver disease (NAFLD/NASH), conditions frequently observed in the HIV positive population, with minimal drug interactions with antiretroviral therapies. Current and future research continues to investigate the full scope of GLP-1 RAs in HIV management, focusing on metabolic, cardiovascular, and liver health improvements.
People with HIV are taking GLP-1 receptor agonists (GLP-1 RAs) such as semaglutide (Ozempic, Wegovy) and liraglutide (Victoza, Saxenda), and there are several medical reasons for this, including:
✅ 1. Obesity and Metabolic Syndrome in People with HIV
Antiretroviral therapy (ART) has improved survival but is associated with weight gain, central adiposity, insulin resistance, and dyslipidemia.
Many people with HIV develop metabolic syndrome, increasing their risk for cardiovascular disease and type 2 diabetes.
GLP-1 RAs help with:
Weight loss (especially visceral fat)
Glycemic control
Reducing cardiovascular risk factors
📘 Reference: Lake JE. “HIV and the GLP-1 Receptor Agonist Class: Current Evidence and Future Directions.” Current HIV/AIDS Reports (2021). https://doi.org/10.1007/s11904-021-00559-5
✅ 2. Lipodystrophy and Ectopic Fat
HIV-associated lipodystrophy (abnormal fat distribution) includes visceral fat accumulation and lipoatrophy.
GLP-1 RAs may reduce visceral adipose tissue (VAT) and improve hepatic steatosis (fatty liver), which is more common in HIV-positive individuals.
🔍 A small study using liraglutide in HIV patients with central adiposity showed improvements in VAT reduction and insulin sensitivity.
📘 Reference: van Wijk JP, et al. “Liraglutide as a Treatment for HIV-Associated Lipohypertrophy.” Journal of Clinical Endocrinology & Metabolism (2016).
✅ 3. GLP-1s and Liver Health (NAFLD/NASH)
People with HIV are at increased risk for nonalcoholic fatty liver disease (NAFLD).
GLP-1 RAs have shown histological improvement in NASH in the general population and are being considered in HIV-related fatty liver disease as well.
✅ 4. Safety and Interactions
No significant drug–drug interactions between GLP-1 RAs and most antiretroviral therapies have been observed.
Tolerability (nausea, GI upset) is similar to that seen in HIV-negative populations.
✅ 5. Ongoing and Future Studies
Several trials are currently exploring GLP-1 RAs in HIV-positive populations for:
Weight and metabolic management
NAFLD/NASH
Cardiovascular risk reduction
🧪 Example: NCT04830034 – Wegovy for Weight Management in People With HIV
| Use Case in HIV Patients | GLP-1 Role |
|---|---|
| Obesity & central adiposity | Weight loss, VAT reduction |
| Insulin resistance & diabetes | Improve glycemic control |
| Lipodystrophy | Redistribution of visceral fat |
| NAFLD/NASH | Improve liver fat and inflammation |
| Cardiovascular risk | Reduce major risk factors |
Audio Overview (Google NotebookLM)
(8 minutes 12 seconds)
