Are you managing your weight while living with HIV? If you’ve experienced weight gain after starting antiretroviral therapy (ART), you might wonder if new weight loss medications can help. Many people are curious about whether these drugs are safe alongside HIV treatments.

Glucagon-like peptide 1 (GLP-1) receptor agonists like semaglutide (Ozempic and Wegovy) can help manage glucose (blood sugar) levels. These medications are used to treat type 2 diabetes and obesity (a body mass index of 30 or higher) and may also help people living with HIV.

This article explains how GLP-1 receptor agonists work and how they might interact with ART. As with using any new treatment, it’s important to talk with your HIV doctor before starting GLP-1 drugs. Your health care provider can help you decide if these medications are a safe and effective choice for your care plan.

What Are GLP-1 Drugs, and How Do They Work?

GLP-1 receptor agonists are a class of medications that help people control blood sugar (glucose) levels. These drugs mimic the action of a hormone in the body called glucagon-like peptide 1. GLP-1 increases insulin production, which helps lower blood sugar. GLP-1 receptor agonists work by acting like GLP-1, leading to reduced blood sugar levels, slower digestion, and decreased hunger.

In addition to raising insulin levels, GLP-1 drugs can:

• Prevent the release of glucagon, a hormone that raises blood sugar levels
• Slow stomach emptying, which limits how much sugar from food enters the bloodstream
• Help you feel less hungry, which may control cravings so that you eat less

Together, these effects help manage blood sugar levels. Other potential benefits of GLP-1 drugs include:

• Lower cholesterol
• Lower blood pressure
• Reduced risk of heart disease
• Improved kidney function
• Better control of lipid (blood fat) disorders
• Improvements in fatty liver disease

As GLP-1 drugs gain popularity for their role in weight loss, you might be curious about trying them to manage your body weight while on ART. Around 78 percent of myHIVteam members surveyed said that they believe having a healthy body weight is important when living with HIV. Health care providers often recommend a balanced diet and regular physical activity to help avoid weight gain with HIV. This is where GLP-1 drugs may be able to help.

However, if you’re taking both GLP-1 drugs and ART, it’s important to be aware of potential side effects and drug interactions. These treatments may affect each other, so be sure to discuss with your health care provider whether taking GLP-1 drugs alongside ART is right for you.

Can GLP-1 Drugs Interact or Interfere With ART?

When you take more than one medication, one drug can affect or change how the other works. This is called a drug-drug interaction. For example, some ART drugs, like atazanavir (Reyataz) and rilpivirine (Edurant), need high levels of stomach acid for proper absorption. Because GLP-1 receptor agonists can reduce the release of this acid, they might affect how well these ART drugs work. Although this specific interaction isn’t highlighted in the federally approved clinical practice guidelines for ART, it could still be relevant in certain cases. That’s why it’s important to talk with your health care provider before taking GLP-1 drugs alongside ART.

Drug-drug interactions can pose health risks if not managed properly. So far, there’s no strong evidence of drug-drug interactions between GLP-1 drugs and ART. However, ART regimens are often complex combinations of drugs, and many people living with HIV use different ART regimens. Not all ART strategies have been fully studied for interactions with GLP-1 drugs, so personalized recommendations are important.

It’s also essential to consider overlapping side effects when taking GLP-1 drugs along with ART. These medications share common side effects such as:

• Loss of appetite
• Diarrhea
• Nausea
• Vomiting

Taking these medicines together could make these side effects worse. In some cases, the side effects may be mild and go away on their own, or your health care provider may decide to adjust your dosage. Always talk with your doctor first before stopping any medication.

It’s also worth considering that certain types of ART, such as protease inhibitors, can increase blood sugar levels and contribute to the development of diabetes in people living with HIV. Because GLP-1 drugs lower blood sugar, they may help reduce the risk of diabetes in those on ART.

Is It Safe To Take GLP-1 Drugs With ART?

Although the full effects of GLP-1 receptor agonists when taken with ART aren’t completely understood, there are currently no major safety concerns. However, since GLP-1 drugs are cleared through the kidneys, people with kidney issues may need extra monitoring. You might also need to keep an eye on your blood sugar levels. Some ART regimens can affect blood sugar, so it’s crucial for your health care provider to monitor this if you’re taking GLP-1 drugs. These checks can often be added to your routine visits.

Like any medication, GLP-1 drugs bring some potential risks. These medications may not be safe for people with a history of mental illness, certain inflammatory diseases, or cancer. Additionally, GLP-1 drugs can reduce muscle mass, which may be a concern for people with HIV who already experience muscle wasting — a condition also linked to ART. It’s essential to discuss your complete medical history with your health care provider to ensure that GLP-1 drugs are safe for you.

On the positive side, some GLP-1 drugs may offer additional benefits, especially for people with heart problems or kidney disease. For example, semaglutide has been shown to improve heart and kidney health.

Researchers are actively studying the safety and effectiveness of GLP-1 drugs in people living with HIV. Two ongoing clinical trials are exploring the effects of semaglutide in this population. A study in Ireland is looking into whether semaglutide can help people with HIV lose weight. In the United States, a study is examining whether semaglutide can reduce fat buildup in people with HIV. The findings will help guide options for weight loss in people living with HIV.

Talk With Your Doctor About GLP-1 Drugs and HIV

In the United States, some people living with HIV who have metabolic complications from ART are already using GLP-1 receptor agonists. Early data suggests that GLP-1 drugs can help some people on ART reduce body weight by 5 percent or more after one year. If you’re having trouble managing your weight while on ART, talk with your doctor. Together, you can decide if GLP-1 drugs might support your health goals.

Everyone’s experience with ART or other medications is unique, so it’s important to work closely with your health care provider to develop a plan tailored to your needs. Be sure to discuss any new symptoms, such as differences in appetite, any weight changes, or new side effects. This can help ensure that both your HIV and your weight are managed effectively. With careful planning, GLP-1 drugs might contribute to improving your overall quality of life.

Talk With Others Who Understand

On myHIVteam, the social network for people with HIV and their loved ones, more than 42,000 members come together to ask questions, give advice, and share their stories with others who understand life with HIV.

Have you had trouble maintaining a healthy weight on ART? Are you curious if GLP-1 agonist drugs can help you achieve your health goals? Share your experiences or questions in the comments below, or start a conversation on your Activities page.