Steven Grinspoon, MD, on the Importance of Studying Treatments for Steatosis in HIV
In this video, Steven Grinspoon, MD, talks about why treatments for steatosis in HIV are important to study, including some reasons why most studies in nonalcoholic fatty liver disease (NAFLD) do not include patients with HIV.
- Grinspoon, SK. Mechanisms and treatments of steatosis in HIV. Presented at: Conference on Retroviruses and Opportunistic Infections 2021; March 7-10, 2021. https://ww2.aievolution.com/cro2101/index.cfm?do=abs.viewAbs&abs=1032
- Stanley TL, Fourman LT, Feldpausch MN, et al. Effects of tesamorelin on non-alcoholic fatty liver disease in HIV: a randomised, double-blind, multicentre trial [published online October 29, 2019]. Lancet HIV. https://doi.org/10.1016/S2352-3018(19)30338-8
Steven K. Grinspoon, MD, is a professor of medicine and director of the Nutrition Obesity Research Center at Harvard Medical School in Boston, Massachusetts. He is also the chief of the Metabolism Unit and the MGH Endowed Chair in Neuroendocrinology and Metabolism at Massachusetts General Hospital in Boston, Massachusetts.
Dr Steven Grinspoon: I'm Dr. Steven Grinspoon. I'm a professor of medicine at Harvard Medical School. I'm Chief of the Metabolism Unit at MGH, and I've had a longstanding interest in the metabolic complications of HIV, including fatty liver disease.
There is some fear in the general population that HIV patients are too sick to be studied, which is completely untrue. They're generally a very stable population, but they have a lot of comorbidities, including NAFLD. They may have more NAFLD than the general population, so they're incredibly important to study.
They should be included in studies of the general population. That's true. We have to make sure that the drugs that we try in them are safe. Tesamorelin is already approved for HIV, so obviously, it's generally safe.
Other agents that could be tried...we always have to wonder about safety and the potential interactions, but if you think carefully about it, there is room to include HIV patients in trials in the general population and/or to direct those trials in the HIV population. One way or another, the HIV population has to be studied, and it could be done one or both ways, and that's important.
For example, studying semaglutide in HIV after we know that it works in non‑HIV, that's a good idea. Or maybe studying both HIV and non‑HIV patients on another drug is a good idea. There's room for both, but the most critical thing is, given the high prevalence of NAFLD and HIV, it has to be studied.
I'd like to thank the audience who are watching this and for the people who participate in the symposium. Thank you so much.