Visceral fat reduction with tesamorelin is associated with improved liver enzymes in HIV

AIDS. 2017 Oct 23;31(16):2253-2259. doi: 10.1097/QAD.0000000000001614.


Objective: Tesamorelin reduces visceral adipose tissue (VAT) in HIV. We investigated whether reductions in VAT with tesamorelin are associated with changes in alanine aminotransferase (ALT) and aspartate aminotransferase (AST).

Design and methods: We utilized data from two multicenter Phase III trials of tesamorelin among 806 HIV-infected patients with abdominal obesity. These studies showed that the majority of patients treated with tesamorelin are 'responders', defined a priori by the Food and Drug Administration as achieving at least 8% reduction in VAT. In the current analysis, we sought to examine the impact of VAT reduction on ALT and AST among patients participating in the Phase III trials with baseline elevated ALT or AST. Within this group, we compared changes in ALT and AST in VAT responders vs. nonresponders after 26 weeks of treatment, and then assessed the effects of drug discontinuation on these endpoints over a subsequent 26-week period.

Results: At baseline, VAT was positively associated with ALT (P = 0.01). In study participants assigned to tesamorelin with baseline ALT or AST more than 30 U/l, VAT responders experienced greater reductions in ALT (-8.9 ± 22.6 vs. 1.4 ± 34.7 U/l, P = 0.004) and AST (-3.8 ± 12.9 vs. 0.4 ± 22.4 U/l, P = 0.04) compared with nonresponders over 26 weeks. This improvement among VAT responders persisted over 52 weeks even in those switched to placebo despite a partial reaccumulation of VAT.

Conclusion: A clinically significant VAT reduction with tesamorelin was associated with improved liver enzymes among HIV-infected patients with abdominal obesity and elevated baseline transaminases.

Trial registration: NCT00123253 NCT00435136 NCT00608023.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alanine Transaminase / blood*
  • Anti-Obesity Agents / therapeutic use*
  • Aspartate Aminotransferases / blood*
  • Clinical Trials, Phase III as Topic
  • Fatty Liver / pathology*
  • Female
  • Growth Hormone-Releasing Hormone / analogs & derivatives*
  • Growth Hormone-Releasing Hormone / therapeutic use
  • HIV Infections / complications*
  • Humans
  • Intra-Abdominal Fat / pathology
  • Male
  • Middle Aged
  • Obesity / complications*
  • Obesity / drug therapy
  • Placebos / administration & dosage
  • Treatment Outcome
  • Young Adult


  • Anti-Obesity Agents
  • Placebos
  • Growth Hormone-Releasing Hormone
  • Aspartate Aminotransferases
  • Alanine Transaminase
  • tesamorelin

Associated data