Weight Loss Associated with Semaglutide Treatment Among People with HIV

Purpose: There is limited real-world evidence about the effectiveness of semaglutide for weight loss among people with HIV (PWH). We aimed to investigate weight change in a US cohort of PWH who initiated semaglutide treatment. Methods: We conducted an observational study using data from the Centers for AIDS Research Network of Integrated Clinical Systems (CNICS) cohort. We identified adult PWH who initiated semaglutide between 2018 and 2022 and with ≥2 weight measurements. The primary outcome was within-person bodyweight change (kg/year). The secondary outcome was within-person Hemoglobin A1c percent (HbA1c) change per year. Both outcomes were estimated using multivariable linear mixed model. Results: In total, 222 new users of semaglutide met inclusion criteria. Mean follow up was 1.1 years. Approximately 75% of new semaglutide users were male, and at baseline, mean age was 53 years (standard deviation [SD]: 10), average weight was 108 kg (SD: 23), mean body mass index was 35.5 kg/m , mean HbA1c was 7.7% and 77% had clinically recognized diabetes. At baseline, 97% were on ART and 89% were virally suppressed (VL < 50 copies/mL). In the adjusted mixed model analysis, treatment with semaglutide was associated with significant weight loss of 6.47 kg per 1 year (95% CI: -7.67 to -5.18) and with a reduction in HbA1c of 1.07% per 1 year (95% CI -1.64 to -0.50) among the 157 PWH with a post-index HbA1c value. Conclusions: Semaglutide was associated with significant weight loss and HbA1c reduction among PWH, comparable to results of previous studies from the general population.