Effects of Tesamorelin on Liver Fat and Histology in HIV+NAFLD

In this video, Lindsay T. Fourman, MD, talks about the effects of tesamorelin on liver fat and histology in patients with HIV and nonalcoholic fatty liver disease. 

Additional Resources:

• Fourman LT, Stanley TL, Feldpausch M, et al. Clinical predictors of liver fibrosis presence and progression in HIV-associated NAFLD. Paper presented at: Conference on Retroviruses and Opportunistic Infections; March 8-11, 2020. Boston, Massachusetts. http://www.croiconference.org/sessions/clinical-predictors-liver-fibrosis-presence-progression-hiv-associated-nafld. 
• Clinical Predictors of Liver Fibrosis Presence and Progression in HIV-Associated NAFLD
• Hepatic and Metabolic Characteristics of Patients With HIV and NALFD
• How NAFLD Affects Patients With HIV Differently Than the General Public
• Take-Away Messages About Liver Fibrosis in Patients With HIV+NAFLD

Lindsay T. Fourman, MD, is a physician at Massachusetts General Hospital in Boston, Massachusetts.

TRANSCRIPT:

Lindsay T. Fourman:  We have done a previous clinical trial looking at tesamorelin to treat NAFLD in HIV, and our primary endpoint in this study was looking for a reduction in the liver fat. That we did actually find.

We found that tesamorelin reduced liver fat by about 30% as a relative reduction compared to placebo, which was exciting because this is the first positive clinical study of NAFLD medication in people with HIV.

This could potentially offer a treatment and not only that, but this medication is already FDA‑approved in people with HIV to treat increased visceral fat. If you know that you have a patient that also has NAFLD, it may be particularly beneficial for these patients.

Very interestingly in addition to that, as a secondary endpoint, we found that tesamorelin also prevented fibrosis progression in the liver. In the placebo‑treated arm, as I alluded to, over 30% of patients had progression, about 38%. In the tesamorelin arm, this was only about 10%.

This is a very intriguing finding and it does tie in nicely with the results of the fibrosis progression predictors that we found, which I'm presenting at CROI, in that a strategy that reduces visceral fat also prevented fibrosis progression, which makes a lot of sense given that we saw that visceral fat at baseline was the only predictor that we found for fibrosis progression in our subsequent study.