{
  "abstract": "Background Health-related quality of life (HRQoL) is the fourth 90% target in HIV care, yet remains largely unmet. Antiretroviral therapy (ART) is the only pharmacological intervention consistently shown to improve HRQoL in people with HIV (PWH), while additional gains have mainly been demonstrated through psychosocial or lifestyle interventions. In the general population, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are associated with modest but significant improvements in HRQoL, particularly in physical and weight-related domains. However, no evidence exists regarding their impact on HRQoL in PWH, who face a disproportionate burden of metabolic comorbidities. We aimed to assess whether GLP-1 therapy may improve HRQoL in this population, alongside metabolic benefits.Methods This prospective study included 25 PWH with metabolic complications prescribed semaglutide at the Modena HIV Metabolic Clinic, Italy, from January 2020 to September 2025. Baseline was GLP-1 initiation; follow-up was the latest available visit (≥6 months) and included demographics, HIV history, anthropometric and metabolic parameters, liver elastography, lipids, glycemic profile, and cardiovascular risk scores. HRQoL was assessed with EQ-5D-5L and EQ-VAS. Linear regression explored associations between weight loss and HRQoL improvement. We also evaluated the proportion achieving optimal HRQoL (>90% EQ-5D-5L index).Results Participants were mostly male (88%), median age 60 years, median HIV duration 28 years, and with high comorbidity burden (68% diabetes, 56% hypertension). Median follow-up was 388 days. Significant improvements were observed in weight, BMI and visceral adipose tissue, total and LDL cholesterol and CAP ( table 1). HRQoL significantly improved: EQ-5D-5L index increased from 0.857 to 0.910 (Δ +0.031; p<0.01). Improvements were evident in pain/discomfort domains and self-rated health (figure 1). At baseline, 8 patients (32%) had HRQoL >90%. At follow-up, 15 patients (60%) achieved this threshold, a net gain of 28%.Conclusions GLP-1 therapy in PWH was associated with improvements in HRQoL, beyond its metabolic benefits. This may represent one of the first pharmacologic interventions after ART to demonstrate a measurable impact on quality of life in this population. These findings suggest GLP-1s could contribute to achieving the fourth 90% UNAIDS target, historically reached mainly through psychosocial approaches.Abstract OC4 Table 1Summary of anthropometric and metabolic outcomesAbstract OC4 Figure 1Changes in EQ-5D-5L and its domains between baseline and follow-up",
  "authors": [
    {
      "affiliations": [
        "Infectious Disease Clinic, Azienda Ospedaliero-Universitaria Policlinico di Modena - Modena HIV Metabolic Clinic, Modena, Italy"
      ],
      "name": "M Menozzi"
    },
    {
      "affiliations": [
        "Infectious Disease Clinic, University of Modena and Reggio Emilia, Modena HIV Metabolic Clinic, Modena, Italy"
      ],
      "name": "J Milic"
    },
    {
      "affiliations": [
        "Infectious Disease Clinic, Azienda Ospedaliero-Universitaria Policlinico di Modena - Modena HIV Metabolic Clinic, Modena, Italy"
      ],
      "name": "G Cuomo"
    },
    {
      "affiliations": [
        "Infectious Disease Clinic, Azienda Ospedaliero-Universitaria Policlinico di Modena - Modena HIV Metabolic Clinic, Modena, Italy"
      ],
      "name": "A Cervo"
    },
    {
      "affiliations": [
        "Infectious Disease Clinic, Azienda Ospedaliero-Universitaria Policlinico di Modena - Modena HIV Metabolic Clinic, Modena, Italy"
      ],
      "name": "G Mancini"
    },
    {
      "affiliations": [
        "Infectious Disease Clinic, University of Modena and Reggio Emilia, Modena HIV Metabolic Clinic, Modena, Italy"
      ],
      "name": "C Mussini"
    },
    {
      "affiliations": [
        "Infectious Disease Clinic, University of Modena and Reggio Emilia, Modena HIV Metabolic Clinic, Modena, Italy"
      ],
      "name": "G Guaraldi"
    }
  ],
  "title": "OC4 Semaglutide in people with HIV: a metabolic health intervention toward the fourth 90%",
  "uid": "1ba15170-b1b7-5278-a909-3ea7faed72d1"
}