EVALUATION OF WEIGHT REDUCTION AND METABOLIC PARAMETERS IN HIV COHORT UNDERGOING TREATMENT WITH GLP-1 RECEPTOR AGONISTS AT A LARGE PUBLIC NYC/HHC+ HOSPITAL IN NEW YORK CITY

Abstract

Therapeutic Area

Obesity

Background

Individuals living with HIV who undergo prolonged combined antiretroviral therapy (cART) may experience weight gain as a potential side effect. Many of these individuals are prescribed GLP-1 receptor agonists (RA), which are recognized for their ability to reduce weight. However, there is uncertainty regarding whether cART could serve as a confounding factor, potentially influencing the effectiveness of GLP-1 RA treatment and impeding the attainment of desired outcomes.

Methods

A retrospective study was conducted, reviewing electronic medical records of 239 HIV-positive patients on GLP-1 RA. After applying criteria, 180 patients were analyzed, all on GLP-1 RA for at least 12 weeks. Multivariate logistic regression was used, assessing weight loss, BMI, HbA1c change, and association between weight loss and cART.

Results

Out of 180 participants, 51.67% were male and 48.33% were female, with a mean age of 58.2 (SD +/- 11.09). 82% of participants had diabetes mellitus II type (DMT2). The mean duration of GLP-1 RA treatment was 25.38 months (SD +/- 18.5). Semaglutide was used by 50.5%, liraglutide by 4%, and dulaglutide by 45.5%. Weight gain was observed in 29.4%, weight loss under 5 kg in 34.4%, 5-10 kg loss in 15%, and over 10 kg loss in 21.11%. Mean weight reduction was 2.5 kg (SD +/- 12.5), HbA1c reduction was 1.03% (SD +/- 2.3), and BMI reduction was 0.76 (SD +/- 12.4). No significant association was found between GLP duration and weight reduction. Dolutegravir/Lamivudine showed less weight reduction compared to other cART regimens (OR=0.36, CI 0.13 – 0.97, p=0.044).

Conclusions

We observed expected positive outcomes linked to GLP-1 RA use, leading to improvements in the metabolic profiles of individuals living with HIV on cART. Further analysis is needed to investigate the relationship between weight and improvements in metabolic parameters with different cART regimens. Additionally, it's important to examine potential sex and racial disparities in response to GLP-1 RA therapy among people living with HIV on cART.