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The following is a summary of “Effects of Tesamorelin on Neurocognitive Impairment in Abdominally Obese Persons with HIV,” published in the January 2025 issue of Infectious Disease by Ellis et al.
Abdominal obesity (AO) in virally suppressed (VS) people with HIV (PWH) on antiretroviral therapy (ART) is associated with neurocognitive impairment (NCI), possibly due to visceral adiposity, inflammation, and decreased insulin-like growth factor 1 (IGF-1).
Researchers conducted a retrospective study to investigate whether tesamorelin, a growth hormone-releasing hormone, could reduce AO and increase IGF-1, potentially mitigating NCI in VS PWH.
They compared tesamorelin with standard-of-care (SOC) for NCI in abdominally obese PWH over 6 months. Participants had VS status, NCI, and AO, indicated by elevated waist circumference (WC). Exclusions included conditions other than HIV causing NCI, active substance use disorder, and malignancy.
The results showed 73 participants were randomized 3:2 to tesamorelin or SOC (2 mg subcutaneously daily). The primary outcome, neurocognitive performance at 6 months, showed a trend toward improvement in the tesamorelin group (mean change: 0.146, 95% CI: -0.002 to 0.294, P =0.060), compared to SOC (mean change: 0.103, 95% CI: -0.095 to 0.301, P =0.295), but the between-group difference was not significant (P =0.673).The IGF-1 levels increased without correlation to sRCS or WC. The tesamorelin group showed a greater reduction in WC (median difference -2.7 cm, P =0.015) compared to SOC.
Investigators concluded the tesamorelin treatment effectively reduced WC, and it did not demonstrate any cognitive benefits compared to the control group, suggesting that short-term adipose tissue reduction with tesamorelin might not have a substantial impact on NCI.
Source: academic.oup.com/jid/advance-article-abstract/doi/10.1093/infdis/jiaf012/7954598
