Background
GLP-1 receptor agonists (GLP-1s) were originally approved for diabetes management, and have also been found to be effective for obesity and cardiac risk reduction. Studies using clinical trial data have found that GLP-1s are safe and effective among people with HIV (PWH). However, few data are available describing the overall population of PWH who take a GLP-1.
Methods
The DC Cohort Longitudinal HIV Study is an observational cohort that collects data from the electronic health records of over 13,000 participants in Washington, DC. We evaluated a subset of participants who have HIV and had any prescription containing a GLP-1 or GLP-1/GIP. Initiation was defined as the first date of GLP-1 prescription. We evaluated participant characteristics at the time of GLP-1 initiation. Weight change was analyzed by taking the weight measurement closest to the date of GLP-1 initiation within the 12 months prior and comparing it to the first weight measurement 6-12 months after initiation. We then stratified participants into the following categories: ≥ 10% or < 10% loss of total body weight to align with average weight loss in the literature and evaluated significant differences using a bivariate analysis.
Results
We identified 578 participants in the DC Cohort who were taking a GLP-1, of which 329 had the weight data required for inclusion in the analysis. Participants were prescribed a GLP-1 for an average of 2.6 years and 83% had been previously diagnosed with diabetes. The most common medication was semaglutide (51%) and 65% of participants had a > 3-month gap in their GLP-1 prescriptions. The average BMI at baseline was 36.3 (St. Dev. 8.1) and 79% of participants were obese. On average, participants lost 2.5% of weight after initiating a GLP-1, 31% lost ≥ 5% of weight, and 11% lost ≥ 10% of weight. Weight change ranged from a 25% weight gain to a 39% weight loss over the course of the study period. Those who lost < 10% were more likely to be non-Hispanic Black (p = 0.02) and have a history of diabetes (p < 0.01); no other factors were significantly associated.
Conclusions
Most participants receiving GLP-1s in a cohort of PWH had a history of diabetes. Nearly a third of participants lost ≥ 5% of weight after initiating GLP-1 and those with ≥ 10% weight loss differed by race and diabetes status. Future research should evaluate whether other HIV-related clinical factors are significantly associated with weight loss after GLP-1 initiation among PWH.
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