Recently, good news about the GLP-1 weight loss drug semaglutide (trade name: Wegovy) has come one after another. It is said that on March 7, 2023, Novo Nordisk revealed at its "Capital Markets Day" event that Wegovy is expected to be approved for listing in China this year. Subsequently, the US FDA announced on March 8 that it had approved Wegovy's new indication - to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and obesity or overweight.
Two studies reported last week at the Retrovirus and Opportunistic Infections Conference in Denver, Colorado, showed that the weight-loss drug semaglutide may help improve the health of HIV patients by reducing the number of infections associated with antibiotics. Retroviral treatment was associated with weight and fat accumulation and also reduced their chronic inflammatory response.
Among people living with HIV, the number of people who are overweight or obese is increasing, sparking interest in drugs like semaglutide among affected patients and doctors. However, so far, few studies have looked at the impact of these best-selling weight-loss drugs on HIV-infected people.
Semaglutide is a type of GLP-1 receptor agonist developed by Novo Nordisk. It controls appetite by simulating glucagon-like peptide 1, thereby achieving blood sugar lowering and weight loss. The drug is called Wegovy when used to treat obesity and Ozempic when used to treat diabetes.
Although the incidence of obesity in people with HIV is similar to trends in the general population, certain antiretroviral therapies used to suppress the HIV virus may contribute to weight gain and related morbidity in these patients. In addition, antiretroviral therapy is associated with abnormal fat accumulation, a metabolic-related fatty liver disease that affects approximately 30% to 40% of HIV-infected individuals. As the disease progresses, it can lead to liver failure and cardiovascular disease.
People with HIV are susceptible to more severe fatty liver disease, and there are currently no approved drugs to treat this condition.
Recent research data shows that among 222 HIV-infected patients treated with semaglutide, these patients lost an average of 6.5 kilograms in approximately one year, equivalent to 5.7% of their initial body weight.
At the Conference on Retroviruses and Opportunistic Infections, Jordan Lake of the University of Texas Health Science Center at Houston reported on the effectiveness of weekly injections of semaglutide for about six months in HIV patients with metabolic dysfunction-related fatty liver disease. The effectiveness of treatment in infected people. The study results showed that 29% of patients experienced complete remission of fatty liver disease. Jordan Lake noted that the study observed a significant reduction in patients' abnormal accumulation of liver fat, even over a short period of time.
The study also found that patients who received semaglutide experienced a decrease in muscle mass, with individuals aged 60 and older being most affected. Older HIV-infected individuals are more susceptible to semaglutide-related muscle loss and require close monitoring by their healthcare provider. It is worth noting that despite the success of GLP-1 weight loss drugs, more and more companies are beginning to focus on muscle-building therapies to combat the loss of muscle mass that may be caused by rapid weight loss.
In addition, there was a report at the Retrovirus and Opportunistic Infections Conference on the use of semaglutide in the treatment of lipohypertrophy in HIV patients. The disease is primarily characterized by abdominal fat accumulation, accompanied by increased inflammation and increased cardiometabolic risk. Current treatments for this disease are limited and ineffective.
In the report, Allison Eckard of the Medical University of South Carolina conducted a clinical trial in HIV-infected people with fatty liver disease. The results showed that semaglutide helped reduce abdominal fat accumulation in patients, and that patients who used semaglutide had nearly 40% lower levels of the inflammatory blood marker C-reactive protein than those who did not use it. This may have important positive consequences for people living with HIV, as even people living with HIV in good disease status may develop a chronic inflammatory state, and this increased inflammation may contribute to various end-organ diseases, including cardiovascular disease, and may Affects liver, kidneys, brain and cognitive function.
Comprehensive recent clinical studies show that semaglutide not only helps HIV-infected patients lose weight, but also reduces their fat accumulation and related chronic inflammation. This suggests that people living with HIV may be the latest group to benefit from GLP-1 weight-loss drugs. If the therapeutic efficacy of these early clinical studies is confirmed, GLP-1 weight loss drugs such as semaglutide may be key to controlling the metabolic problems often caused by HIV treatment.
Reference: https://www.nature.com/articles/d41586-024-00691-8
