A recent study suggests that semaglutide injections could help improve brain function in adults living with HIV (PWH). The research, which involved 108 participants, showed that semaglutide was linked to significant improvements in cognitive abilities.
The Link Between HIV and Cognitive Decline
People with HIV are known to face a higher risk of cognitive issues, alongside problems like increased fat around internal organs and greater inflammation. These factors have been shown to negatively affect brain function. Dr. Ornina Atieh, a postdoctoral fellow at Case Western Reserve University, highlighted these challenges in her presentation at the 2025 Conference on Retroviruses and Opportunistic Infections.
However, previous studies have shown that semaglutide can help reduce weight, visceral fat, and high levels of inflammation, which are known to affect cognitive function in people with HIV.
The Study: Examining Semaglutide’s Effects on Brain Function
This study is the first randomized, placebo-controlled trial to test the effects of semaglutide, a glucagon-like peptide 1 receptor agonist (GLP-1 RA), in people with HIV. The research aimed to evaluate how semaglutide affects cognitive function, taking into account improvements in fat levels and inflammation markers.
The study involved 108 adults with HIV who were on antiretroviral therapy. They were randomly assigned to receive either semaglutide or a placebo once a week for 32 weeks. Cognitive function was assessed at the start and end of the study using Cognivue, an FDA-approved computer-based test. Participants’ average age was 53, with 40% women and 62% non-White individuals.
Results: Significant Cognitive Improvements
After 32 weeks, the group receiving semaglutide showed significant improvements in areas like visuospatial abilities, naming/language skills, and delayed recall compared to the placebo group. However, only the visuospatial improvement remained significant after adjusting for factors like sex and CD4 count.
Exploring the Role of Weight and Inflammation
The researchers then looked at whether changes in weight, fat levels, or inflammation markers could explain the cognitive improvements. While semaglutide had a significant effect on visuospatial function, changes in weight or fat did not seem to play a major role in the improvement. Inflammation, however, was found to be a factor in the visuospatial improvement.
Challenges and Future Directions
Although semaglutide showed promise, the study’s small sample size and short duration (32 weeks) limit the conclusions that can be drawn. Larger and longer studies are needed to confirm these findings and to explore the long-term effects of semaglutide on cognitive function in people with HIV.
Dr. Grace A. McComsey, senior author of the study, emphasized that while treatment options for both visceral fat and cognitive dysfunction in HIV are limited, semaglutide could potentially address both issues simultaneously. However, more research is needed to fully understand how semaglutide affects cognitive decline in people with HIV.
