BACKGROUND Weight gain and associated metabolic complications are increasingly prevalent among people with human immunodeficiency virus (PWH). Glucagon-like peptide 1 receptor agonists (GLP-1RAs) are incretin-based therapies for diabetes and weight management that have been shown to result in substantial weight loss; however, studies of their effects in PWH are limited. METHODS A retrospective single-center cohort study was conducted among PWH who were taking GLP-1RAs at the University of California, San Diego Owen Clinic between 1 February 2021 and 1 February 2023. Baseline clinical data were collected and changes in weight, body mass index (BMI), and hemoglobin A1C (A1C) before starting GLP-1RAs compared to the most recent clinic visit were calculated (with a minimum of 3 months follow-up time required). Logistic regression was performed to identify variables associated with >5% of total body weight loss. RESULTS A total of 225 patients received on average 13 months of GLP-1RA therapy, with 85 (37.8%) achieving the maximum GLP-1RA dose. GLP-1RA therapy resulted, on average, in a weight loss of 5.4 kg, decrease in BMI by 1.8 kg/m2, and decrease in A1C by 0.6%. In the multivariable analysis, higher baseline BMI (odds ratio [OR], 1.10 [95% confidence interval {CI}, 1.03-1.16]), treatment duration of GLP-1RA therapy >6 months (OR, 3.12 [95% CI, 1.49-6.49]), and use of tirzepatide (OR, 5.46 [95% CI, 1.44-20.76]) were significantly more likely to be associated with >5% weight loss. CONCLUSIONS Use of GLP-1RAs led to declines in weight, BMI, and A1C among PWH and offers an additional strategy to address weight gain and diabetes.

中文翻译：

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胰高血糖素样肽 1 受体激动剂可促进 HIV 感染者的体重减轻。


背景 体重增加和相关代谢并发症在人类免疫缺陷病毒 （PWH） 患者中越来越普遍。胰高血糖素样肽 1 受体激动剂 （GLP-1RAs） 是基于肠促胰岛素的糖尿病和体重管理疗法，已被证明可显着减轻体重;然而，关于它们在 PWH 中影响的研究有限。方法 在 2021 年 2 月 1 日至 2023 年 2 月 1 日期间在加州大学圣地亚哥分校欧文诊所服用 GLP-1RAs 的 PWH 中进行了一项回顾性单中心队列研究。收集基线临床数据，并计算与最近一次门诊就诊相比，开始 GLP-1RAs 前体重、体重指数 （BMI） 和血红蛋白 A1C （A1C） 的变化 （至少需要 3 个月的随访时间）。进行 Logistic 回归以确定与总体重减轻 >5% 相关的变量。结果 共有 225 例患者平均接受了 13 个月的 GLP-1RA 治疗，其中 85 例 （37.8%） 达到了 GLP-1RA 的最大剂量。GLP-1RA 疗法平均导致体重减轻 5.4 kg，BMI 降低 1.8 kg/m2，A1C 降低 0.6%。在多变量分析中，较高的基线 BMI （比值比 [OR]，1.10 [95% 置信区间 {CI}，1.03-1.16]）、GLP-1RA 治疗的治疗持续时间 >6 个月 （OR，3.12 [95% CI，1.49-6.49]） 和 tirzepatide 的使用（OR，5.46 [95% CI，1.44-20.76]） 与 >5% 体重减轻相比显著更可能相关。结论 GLP-1RAs 的使用导致 PWH 的体重、BMI 和 A1C 下降，并提供了一种解决体重增加和糖尿病的额外策略。