College of Pharmacy, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Medicine, University of Washington, Seattle, WA.
AIDS. 2024 Mar 15;38(4):531-535. doi: 10.1097/QAD.0000000000003791. Epub 2023 Nov 16.
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.
Observational study using 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 at least two weight measurements. The primary outcome was within-person bodyweight change in kilograms at 1 year. The secondary outcome was within-person Hemoglobin A1c percentage (HbA1c) change. Both outcomes were estimated using multivariable linear mixed model.
In total, 222 new users of semaglutide met inclusion criteria. Mean follow-up was 1.1 years. Approximately 75% of new semaglutide users were men, and at baseline, mean age was 53 years [standard deviation (SD): 10], average weight was 108 kg (SD: 23), mean BMI was 35.5 kg/m 2 , mean HbA1c was 7.7% and 77% had clinically recognized diabetes. At baseline, 97% were on ART and 89% were virally suppressed (viral load < 50 copies/ml). In the adjusted mixed model analysis, treatment with semaglutide was associated with an average weight loss of 6.47 kg at 1 year (95% CI -7.67 to -5.18) and with a reduction in HbA1c of 1.07% at 1 year (95% CI -1.64 to -0.50) among the 157 PWH with a postindex HbA1c value.
Semaglutide was associated with significant weight loss and HbA1c reduction among PWH, comparable to results of previous studies from the general population.
关于接受司美格鲁肽治疗的艾滋病毒感染者（HIV 感染者）人群的减重效果，目前实际证据有限。本研究旨在调查美国 HIV 感染者人群中使用司美格鲁肽治疗的体重变化情况。
利用艾滋病研究联合会综合临床系统（CNICS）队列进行观察性研究。
我们确定了 2018 年至 2022 年期间开始使用司美格鲁肽治疗且至少有两次体重测量的成年 HIV 感染者。主要结局是 1 年内的个体体重变化（以公斤计）。次要结局是个体血红蛋白 A1c 百分比（HbA1c）的变化。使用多变量线性混合模型估计这两个结局。
共有 222 名新使用司美格鲁肽的患者符合纳入标准。平均随访时间为 1.1 年。大约 75%的新司美格鲁肽使用者为男性，基线时平均年龄为 53 岁（标准差 [SD]：10），平均体重为 108 公斤（SD：23），平均 BMI 为 35.5kg/m 2 ，平均 HbA1c 为 7.7%，77%的患者有临床诊断的糖尿病。基线时，97%的患者正在接受抗逆转录病毒治疗，89%的患者病毒载量受到抑制（病毒载量＜50 拷贝/ml）。在调整后的混合模型分析中，与治疗前相比，使用司美格鲁肽治疗 1 年后平均体重减轻 6.47kg（95%置信区间：-7.67 至-5.18），HbA1c 降低 1.07%（95%置信区间：-1.64 至-0.50）。在 157 名有治疗后 HbA1c 值的 HIV 感染者中。
司美格鲁肽可显著减轻 HIV 感染者的体重并降低 HbA1c，其效果与一般人群的既往研究结果相当。
