Impact of semaglutide on liver fibrosis score in people with HIV: findings from the CNICS cohort

作者：Jimmy Ma, Stephanie A. Ruderman, Lara Haidar, Joseph A. Delaney, H. Nina Kim, Diana Alba, Kristina Crothers, Sherif Eltonsy, Sonya Heath, Y Joseph Hwang, Maile Karris, Kenneth H. Mayer, Sonia Napravnik, April C. Pettit, Anamaria Rodriguez, Bridget M. Whitney, George Yendewa, Michael S. Saag, Mari M. Kitahata, Heidi M. Crane · 发表于：AIDS · 年份：2026 · DOI：10.1097/qad.0000000000004544 · 被引用次数：1 · 研究领域：HIV-related health complications and treatments、Liver Disease Diagnosis and Treatment、HIV/AIDS drug development and treatment

OBJECTIVES: Metabolic dysfunction-associated steatotic liver disease (MASLD) and liver fibrosis are key drivers of morbidity and mortality in people with HIV (PWH). Limited evidence exists in PWH for managing MASLD and liver fibrosis with semaglutide. METHODS: We studied adult PWH in care at 10 CFAR Network of Integrated Clinical Systems sites who initiated semaglutide for diabetes and/or weight loss and had liver fibrosis score (FIB-4) data from 4/2018-11/2024. We used adjusted linear mixed models for a quasi-experimental, pre-/post-, new-user analysis of semaglutide on FIB-4 score with several a priori stratifications by baseline fibrosis category and other relevant clinical factors. RESULTS: Among 1850 PWH at baseline, 1368 had FIB-4 <1.3 (no/low fibrosis), 428 had FIB-4 1.3-2.67 (moderate fibrosis), and 54 had FIB-4 >2.67 (advanced fibrosis). Most PWH had cardiometabolic conditions (diabetes 59%, dyslipidemia 62%, hypertension 80%, BMI ≥30 80%), drank alcohol with low levels of use (57%, mean AUDIT-C 1.6), and did not have hepatitis B (93%) or hepatitis C infection (86%). Mean time on semaglutide was 218 days. Semaglutide was associated with reductions in liver fibrosis score in PWH with baseline moderate-to-advanced fibrosis (FIB-4: ≥1.3; ΔFIB-4: -0.11, P < 0.01) with greatest decreases in advanced fibrosis (FIB-4: >2.67; ΔFIB-4: -0.64, P < 0.001). CONCLUSIONS: Semaglutide was associated with declines in liver fibrosis scores in PWH with moderate-to-advanced fibrosis and...