Efficacy and acceptability of liraglutide for obesity in people with HIV: results of an open-label clinical trial in South Africa

Twelve weeks of liraglutide plus lifestyle counselling was followed by meaningful reductions in weight, waist circumference and HbA1c in people with HIV and obesity in rural South Africa, and by improvements in depressive symptoms, sleep and psychological quality of life. The intervention appeared acceptable, with most participants completing the study. However, weight and waist circumference rebounded after treatment was stopped.

Journal article — Phase IV open-label clinical trial. Population: People with HIV and BMI ≥ 30 kg/m2 in rural South Africa. Sample size: 40 PWH. Follow-up: 12 weeks of treatment plus follow-up to 24 weeks. Interventions: liraglutide 3.0 mg daily; lifestyle counselling. Cited by 1 other paper.

Fifty-two participants were screened; 44 (85%) were eligible and 40 (91%) consented to enroll. Thirty-eight of 40 (95%) completed the study, with 2 (5%) stopping because of relocation. Mean weight fell by 2.9%, waist circumference by 5.6 cm and HbA1c by 0.3 percentage points, and depressive symptoms, sleep quality and psychological quality of life improved significantly. After stopping liraglutide, weight and waist circumference rebounded significantly, while changes in depression, sleep quality and quality of life were negligible. The study intervention was reported as acceptable based on the enrollment fraction and retention.

Researchers studying liraglutide will care because this is among the first evidence on GLP-1 receptor agonist use for obesity in people with HIV in Southern Africa, linking treatment to improvements in weight, waist circumference, HbA1c and patient-reported outcomes. It does not establish efficacy relative to placebo or other interventions, long-term safety, or durability of benefits after stopping treatment.

Key findings

• Weight decreased by a mean of 2.9% during 12 weeks of treatment.
• Waist circumference decreased by a mean of 5.6 cm during treatment.
• Mean HbA1c decreased by 0.3 percentage points during treatment.
• Depressive symptoms, sleep quality and psychological quality of life improved significantly with treatment.
• Weight and waist circumference rebounded significantly after treatment discontinuation.
• Of 44 eligible people, 40 (91%) consented to enroll and 38 of 40 enrolled (95%) completed the study.

Limitations

• Open-label, single-arm design without a control group
• Small sample size at a single rural South African site
• Short 12-week treatment period with limited follow-up beyond 24 weeks

The record

• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America: ciag337
• Published: 2026-05-28
• PMID: 42203210 — DOI: 10.1093/cid/ciag337
• Funding: NIDDK NIH HHS
• Author countries: Denmark, South Africa, USA

Peptide profiles: Liraglutide.

All indexed evidence: Liraglutide trials & papers.

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