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Ozempic Helps With Liver Disease in HIV Patients

Semaglutide, the active ingredient of Ozempic and other popular weight loss drugs, is safe and effective in alleviating common liver disease in HIV patients, according to a study sponsored by the National Institutes of Health.

Steatotic liver disease (MASLD), previously known as nonalcoholic fatty liver disease, is characterized by excess fat in the liver that is not caused by alcohol consumption or viral hepatitis.

The condition affects about 30-40% of people with human immunodeficiency virus (HIV), slightly higher than the average among HIV-free people.

The first clinical trial of semaglutide for MASLD in people with HIV found that the drug can significantly reduce the amount of fat in the liver.

The study enrolled 49 participants with MASLD and HIV aged 18 years and older whose viral load — the amount of HIV in the blood — is undetectable due to the use of antiretroviral therapy (ART)

Most (82%) participants were taking ART regimens containing an integrase strand transfer inhibitor. This class of antiretroviral drugs is highly effective at suppressing HIV but is associated with weight gain in some people.

Participants self-injected semaglutide on a weekly basis at increasing doses until they reached a 1-milligram dose at week four. At the same time, they participated in frequent safety monitoring visits. At 24 weeks, their liver fat content was assessed using an MRI.

Participants saw an average 31% reduction in liver fat. Nearly one-third (29%) of participants experienced a complete resolution of MASLD, meaning their liver fat decreased to 5% or less of overall liver content.

They also experienced weight loss, reduced fasting blood glucose, and reduced fasting triglycerides, a type of fat in the blood. Similar semaglutide effects were observed in patients without HIV.

Additionally, the use of semaglutide was linked to the reduction of the volume of the psoas muscle — a large muscle connecting the torso to the lower body — without significant change in physical function.

The most common side effects were gastrointestinal and included nausea, diarrhea, vomiting, and abdominal pain. Two participants experienced more significant adverse events but were able to continue in the study.

Semaglutide and other drugs that belong to the class of GLP-1 receptor agonists were initially developed to treat type 2 diabetes. In recent years, they have been increasingly used for weight loss, often off-label, as they can help to shed approximately 15% of the body weight.

Recent studies have associated semaglutide with other health benefits, including dementia prevention, reduced risk of heart attack, and curbed addictions.

However, there is a growing concern about the severe side effects of GLP-1 receptor agonists. A 2023 study linked semaglutide to an increased risk of pancreatitis, bowel obstruction, and stomach paralysis in individuals without diabetes.

Moreover, the use of GLP-1 receptor agonists was associated with rare but severe psychiatric events, including suicidal ideation.

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