The Effects of Semaglutide on Inflammation and Immune Activation in HIV-associated Lipohypertrophy

作者：Nicholas Funderburg, Allison Ross Eckard, Qian Wu, Abdus Sattar, Kate Ailstock, M.J. Cummings, Danielle Labbato, Grace A. McComsey · 发表于：Open Forum Infectious Diseases · 年份：2025 · DOI：10.1093/ofid/ofaf152 · 被引用次数：5 · 研究领域：HIV-related health complications and treatments、Lipoproteins and Cardiovascular Health、Adipokines, Inflammation, and Metabolic Diseases

Abstract Background Cardiovascular and metabolic comorbidities are common in people with HIV (PWH) and are linked to chronic inflammation and immune activation. We assessed the effects of semaglutide on plasma markers of immune activation/inflammation that are known to be increased in PWH and are associated with morbidity and mortality in this population. Methods We conducted a single-site, randomized, double-blinded, placebo-controlled trial of virologically suppressed, nondiabetic PWH ≥18 years of age on stable antiretroviral therapy with body mass index ≥ 25 kg/m2, increased waist circumference/waist-to-hip ratio, and subjective increased abdominal girth after antiretroviral therapy initiation (clinicaltrials.gov: NCT04019197). Participants were randomized 1:1 to 32 weeks of semaglutide (8-week titration + 24 weeks of 1.0 mg weekly subcutaneous injection) or matching placebo. Signed-rank tests were used to determine changes over 32 weeks in soluble markers and cellular phenotypes of inflammation/immune activation within groups; semaglutide effects were assessed using linear or quantile regression analyses. Results A total of 108 participants were enrolled and evenly randomized to semaglutide versus placebo. Eight (15%) in each group withdrew prematurely. Thirty-two weeks of semaglutide treatment reduced baseline levels of C-reactive protein, interleukin-6, and soluble CD163 (all P < .02) and trended to reduce levels of sCD14 (P = .08). Circulating monocyte proportio...