New findings from research, including research by infectious disease expert Alison Eckardt, M.D., of the Medical University of South Carolina, suggest that people with HIV may benefit from a popular weight loss drug beyond the number on the scale. It shows that there is.

“This is really good research and very timely,” Eckerd said.

She and her colleagues are looking at ways to help people on antiretroviral therapy (ART) combat some of the treatment’s side effects. People on ART tend to gain weight, sometimes in dangerous ways.

Scientists recently presented their latest findings at the Conference on Retroviruses and Opportunistic Infections in Denver. The research team includes researchers from Cleveland University Hospitals, Case Western Reserve University, and The Ohio State University.

Investigation result

Doctors have long sought ways to help people with HIV live healthier lives. Eckerd is pleased to be a part of that effort. This effort led to important new discoveries.

She described the core issues that the team was focused on. “Some people with HIV not only gain weight when they start ART, but also gain excessive amounts of visceral fat. Fat accumulates around internal organs and within the abdominal cavity. “We know that is the bad kind of fat,” she said.

“Our study therefore targets people with what is called HIV-associated lipohypertrophy. Most of the weight gain from HIV treatment is due to abnormal accumulation of visceral fat.”

Visceral fat is different from subcutaneous fat, which can be pinched, and is hidden deep within the body. “The already harmful effects of visceral fat, combined with the negative effects of both HIV and its treatment, create even more dysfunctional fat in the body, leading to higher levels of inflammation. Excessive inflammation. can have negative health effects, especially when chronic,” Eckerd said.

“Heart disease, bone disease, and in the case of HIV, a disease called sarcopenia, which refers to both loss of muscle mass and decreased muscle function, are at increased risk. Metabolic comorbidities such as insulin resistance and diabetes are also common. These complications of the virus and its treatment are common in people with HIV, but the risk is even higher in people with HIV-associated lipohypertrophy.”

Comorbidity means having multiple health problems at once, and is a common problem for people with HIV. “They have, on average, more comorbidities at an earlier age than the general population. Many studies show that they occur about 10 years earlier and occur more frequently,” Eckerd said. he said.

“Maybe someone in the general population develops high blood pressure in their 60s. People with HIV can develop diabetes, high blood pressure, and even heart disease in their 50s. is one of the most pressing concerns and limitations of HIV treatment, because there are very good antiretroviral drugs that allow people to live decades longer than before, but they often , we often struggle with all these additional diagnoses that occur because of the indirect effects of HIV and its treatment.”

Possible new uses for weight loss drugs

Researchers from many fields are studying the effects of new weight loss drugs on a variety of health conditions. Dr. Eckerd’s research shows whether semaglutide (Ozempic, Wegovy) not only helps his HIV-infected people lose weight and potentially reduce the risk of many health conditions, but also reduces inflammation. is focused on.

“One of the main causes of HIV comorbidities is chronic inflammation. People with HIV have more inflammation and less immunity than people without HIV, even if they have an undetectable viral load and are in good health. Dysfunction is more likely to occur,” Eckerd said.

“What we found in our study is that even in our adjusted model, C-reactive protein, which is a major risk factor or predictor for cardiovascular disease, was reduced by 40% over 32 weeks in the semaglutide group versus the placebo group. “And what was really big in our study, compared to some studies on obesity and diabetes, was that the reduction in inflammation was independent of weight loss.”

Eckardt said it’s probably related to the immune dysfunction that occurs with HIV. “We are still investigating why levels of certain inflammatory markers decreased so dramatically, but perhaps semaglutide shifted some of the abnormal immune pathways to healthier ones. But the message we get is that inflammation is reduced, and that’s the most important finding from our data.”

from now on

But more research is needed, she says. “We have to be careful. Although participants showed significant reductions in both visceral and subcutaneous fat and a reduction in lean body mass, this likely included some muscle loss. So I don’t think this drug is suitable for everyone. People living with severe lipoatrophy from the very toxic drugs we used in the early days of the epidemic. I’m still here.”

Lipoatrophy refers to an excessive and unhealthy loss of subcutaneous fat. “To be healthy, we need some amount of subcutaneous fat. So for people with severe lipoatrophy, drugs that cause further loss of subcutaneous fat are not good for them. Also, for some older and frail people, drugs that cause further loss of subcutaneous fat are not good for them. We have to be careful about giving people drugs that can cause further muscle loss, so those are things we’re still figuring out.”