ClinicalTrials.gg
RecruitingNCT04174755SWIFTUpdated Apr 29, 2026

Semaglutide's Efficacy in Achieving Weight Loss for Those With HIV

An interventional study of Semaglutide Injectable Product and Standard of care in Obesity and HIV-1-infection, sponsored by University College Dublin. Recruiting at 1 site in Ireland. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-04-29.

Sponsored by University College Dublin · Not applicable, Interventional, and Treatment

From the registry’s dates

  • Started Jun 2022; still recruiting 4 years 4 months later.
Phase
Not applicable
Study type
Interventional
Enrollment
80
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

The prevalence of obesity is rising worldwide, both in low- and high-income countries, including people with HIV (PWH). Semaglutide's efficacy in achieving weight loss in obese PWH is still unexplored. The aim of this study is to assess the efficacy and safety of semaglutide in achieving greater weight loss compared to diet and excercise alone in obese PWH and to explore the effect of semaglutide on the immune function, markers of immune activation, viral reservoir, markers of glucose and lipid metabolism and gut microbiome.

Read the detailed description

A randomised, controlled, parallel-group, open-label study comparing treatment with the GLP-1 analogue semaglutide in combination with lifestyle interventions to lifestyle interventions alone in obese PWH.

The study will enroll HIV-1 infected patients ≥ 18 years with BMI ≥30kg/m2 or BMI ≥27kg/m2 and hypertension, dyslipidaemia or type 2 diabetes mellitus.

Primary objective: To assess the efficacy of semaglutide as an adjunct to diet and exercise in achieving greater weight loss in obese PWH as compared to diet and exercise alone.

Secondary objectives:

  • To explore the effect of semaglutide on markers of immune function and HIV viral reservoirs in obese PWH.
  • To explore the effect of semaglutide on markers of glucose and lipid metabolism in obese PWH.
  • To explore the effect of semaglutide on markers of inflammation and gut microbial translocation in obese PWH.
  • To assess the safety of semaglutide in obese PWH on stable ART.
02

Conditions studied

  • Obesity
  • HIV-1-infection

Keywords

  • obesity
  • HIV
  • weight loss
  • GLP-1 analogue
  • immune activation
  • viral reservoir
  • gut microbiome
03

In context

Obesity

11,522 studies on the registry are indexed under Obesity; 2,033 are open to participants now.

This study's planned enrollment of 80 is above the median of 67 across 9,006 interventional studies indexed under Obesity.

Browse Obesity studies →

Lead sponsor

University College Dublin is the lead sponsor of 113 studies on the registry; 32 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Be over 18 years old
  • Be -1 antibody positive as determined by a positive 4th generation Ag/Ab ELISA assay
  • Be stable on ART with a viral load suppressed \<40 copies/mL for a minimum of 2 years
  • Have a ≥200 cells/mm3 for a minimum of 1 year
  • Have a ≥30kg/m2 or have a BMI ≥27kg/m2 and hypertension, dyslipidaemia or type 2 diabetes mellitus
  • Understand the study procedures, be able to comply with the study procedures, and voluntarily agree to participate by giving written for the trial

Exclusion criteria

Exclusion Criteria:

  • Subjects unable to comply with the study protocol or unable to self-administer subcutaneous semaglutide
  • History of obesity induced by other endocrine disorders: hypothyroidism, Cushing's syndrome, primary and secondary hypogonadism, hypothalamic disorders, polycystic ovary syndrome, insulinoma
  • History of obesity induced by use of anti-psychotic medications known to be associated with weight gain (i.e. olanzapine, clozapine).
  • Treatment with GLP-1 receptor agonists (including liraglutide, semaglutide or exenatide), dipeptidyl peptidase-4 (DPP-4) inhibitors or insulin within the last 3 months (including saxagliptin, linagliptin, sitagliptin)
  • History of severe renal impairment, as defined by a baseline \<30ml/min
  • Individuals with a diagnosis of -associated lipoatrophy/lipodystrophy, based on physician's assessment
  • Individuals with severe hepatic impairment ( score >9)
  • Subjects with active infection (defined as hepatitis B sAg positive) or (defined as hepatitis C Ab and RNA positive) co-infection
  • Any active illness (including AIDS-defining illness) which in the opinion of the investigator precludes participation in the study
  • History of cancer (apart from treated Kaposi's Sarcoma) and/or receiving chemotherapy or radiotherapy
  • Active illicit intravenous drug use
  • Subjects concurrently enrolled in another clinical trial of an medicinal product.
  • The investigator may decide that a subject cannot proceed in the study if there is any relevant other abnormal results in the screening assessments
  • Subjects with any known or suspected to semaglutide or any of the of semaglutide
  • Subjects on another medicinal product prescribed primarily for weight loss e.g. orlistat (see prohibited/cautioned concomitant medications/therapies section)
  • For female subjects: pregnancy or breastfeeding at screening, planning future pregnancies or unwilling to take measures to avoid pregnancy for the duration of the study
Terms in these criteria, in plain language(11)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

HIV

The human immunodeficiency virus, which weakens the immune system.

Many studies now accept people whose HIV is controlled on treatment, judged by the viral load and the CD4 count. Check the limits this study sets.

CD4 count

The number of CD4 cells, a type of white blood cell, in a given amount of blood. It is used to follow how well the immune system is doing in HIV.

BMI (body mass index)

Weight in kilograms divided by height in metres squared. Example: 70 kg and 1.75 m gives 70 ÷ (1.75 × 1.75) ≈ 22.9.

What counts as overweight or obesity differs between countries (some use lower cut-offs), so go by the range the study states.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Creatinine clearance (CrCl)

How quickly the kidneys clear creatinine, a waste product, from the blood. A study may estimate it from a blood test with age, weight and sex (often by the Cockcroft–Gault formula), or measure it using blood and urine collected over a set time. Given in mL/min; higher is better.

Child-Pugh class

A score of how well the liver works in people with liver disease such as cirrhosis: class A is mild, B moderate and C severe.

Hepatitis B tests

Hepatitis B is a virus that infects the liver. These are separate tests: HBsAg positive usually means a current infection (a recent vaccination can briefly cause it too); total anti-HBc (HBcAb) positive means an infection now or in the past; HBV DNA measures how much virus is in the blood.

Some studies accept a past infection if HBV DNA is undetectable, sometimes with antiviral medicine during the study. Check what this study allows.

Hepatitis C tests

Hepatitis C is a virus that infects the liver. An HCV antibody test can stay positive after an infection has cleared (and is occasionally positive without one); an HCV RNA test shows whether the virus is there now.

After treatment, hepatitis C counts as cured when HCV RNA is still undetectable 12 weeks or more after the treatment ended. Studies often accept people cured this way.

Investigational drug or device

A drug or device being studied in a clinical trial.

It may be new, or already approved and being studied for another use, dose or form. Criteria often leave out people who took part in another study of one within a recent period, commonly 30 days or five half-lives.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Excipients

The other ingredients in a medicine besides the active drug, such as fillers, colours or preservatives.

05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
80 participants (estimated)

Study arms

  • Experimental
    Semaglutide 0.25/0.5/1 mg plus standard of care

    Drug: Semaglutide Injectable Product · Behavioral: Standard of care

  • Other
    Standard of care alone

    Behavioral: Standard of care

Interventions

  • Semaglutide 0.25 mg subcutaneously once weekly for 4 weeks, then Semaglutide 0.5 mg subcutaneously once weekly for 4 weeks, then Semaglutide 1 mg subcutaneously once weekly for 20 weeks. Total treatment duration 28 weeks.

    Also known as: Ozempic

  • BehavioralStandard of care

    Diet and exercise advice for 40 weeks

    Also known as: Diet and exercise

06

What researchers measure

Primary outcomes

  1. Changes in total body weight (in Kg)

    Between-group differences in percent change from baseline to week 28 in total body weight

    Time frame: 28 weeks

Secondary outcomes

  1. Proportion of subjects not achieving 5% weight loss from baseline to week 16

    Between-group differences in number of subjects who do not achieve a 5% weight loss (in Kg) from baseline to week 16

    Time frame: 16 weeks

  2. Changes in numbers and function of immune cell subsets

    Between-group differences in percent change from baseline in numbers and functions of immune cells subsets (NK cells, MAIT cells, T-cells and Monocytes) as assessed through flow cytometry in a single assay

    Time frame: 40 weeks

  3. Changes in quantified viral reservoir in peripheral blood mononuclear cells (PBMCs)

    Between-group differences in percent change from baseline in HIV pro-viral DNA and cell-associated RNA (CA-RNA), measured in PBMCs (copies/mL)

    Time frame: 40 weeks

  4. Changes in gut microbiome composition in stool samples

    Between-group differences in percent change from baseline in gut microbiome composition (% prevalence of different microbial species) as assessed through molecular techniques in stool samples

    Time frame: 40 weeks

  5. Changes in parameters of glucose metabolism in blood samples

    Between-group differences in percent change from baseline in blood glucose levels (in mmol/L), HbA1c (in mmol/mol) and insulin levels (in pmol/L)

    Time frame: 40 weeks

  6. Changes in parameters of lipid metabolism

    Between-group differences in percent change from baseline in lipid profile: total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides (all in mmol/L)

    Time frame: 40 weeks

  7. Proportion of subjects reporting any adverse event

    Between-group differences in the number of subjects reporting any type of adverse event, including serious adverse events and suspected unexpected serious adverse reactions

    Time frame: 40 weeks

  8. Changes in bone mineral density (BMD) and total body composition

    Between-group differences in percent change from baseline in lumbar spine and hip BMD and total body composition (% fat mass and lean mass) as assessed through DXA scan

    Time frame: 40 weeks

  9. Changes in liver stiffness

    Between-group differences in percent change from baseline in liver stiffness (measured in kPa) as assessed thourgh liver elastography

    Time frame: 40 weeks

07

Study locations

1 of 1 sites recruiting
08

References and documents

Publications

  • O'Sullivan L, Savinelli S, O'Hare S, Holden S, McHugh C, Mallon P, Doran P. An enhanced participant information leaflet and multimedia intervention to improve the quality of informed consent to a randomised clinical trial enrolling people living with HIV and obesity: a protocol for a Study Within A Trial (SWAT). Trials. 2022 Jan 17;23(1):50. doi: 10.1186/s13063-021-05979-y. PubMed 35039057 ↗

Individual participant data

Plan to share: No

09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Apr 29, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT04174755
Responsible party
Patrick Mallon (Professor of Microbial Diseases, University College Dublin) — Principal investigator
First posted
Nov 22, 2019
Start date
Jun 22, 2022
Primary completion
Jan 2027 (estimated)
Completion
Jul 2027 (estimated)
Last update
Apr 29, 2026

Study contacts

Stefano Savinelli, MD
Contact
stefano.savinelli1@ucd.ie
+3532215014

Oversight

Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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Studies of the drug tested here: Semaglutide

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