ACTG, a global clinical trials network focused on HIV and other infectious diseases, announced new findings from the SLIM LIVER study (also known as A5371). These data suggest that blood-based epigenetic biomarkers (gene modifications) may help predict how well people living with HIV respond to semaglutide as a treatment for metabolic dysfunction-associated steatotic liver disease (MASLD). These results were presented in the oral abstract, “Epigenetic Age Predictors of Semaglutide-Related Liver Fat Changes in People With HIV,” at the 2025 Conference on Retroviruses and Opportunistic Infections (CROI) in San Francisco, California.

SLIM LIVER was the first clinical trial to test semaglutide as a treatment for MASLD in people living with HIV. MASLD, previously known as non-alcoholic fatty liver disease (NAFLD), is a common and serious condition in which fat builds up in the liver. In people living with HIV, MASLD may cause faster liver damage than in people with MASLD but without HIV and increase the risk of organ dysfunction. While semaglutide (a medication commonly used for weight loss and diabetes) has been associated with cardiometabolic improvements in the general population, the primary analysis of SLIM LIVER was the first time that it was shown to improve, and in some cases resolve completely, MASLD among people living with HIV.