Core Insights - Theratechnologies Inc. presented two significant studies at the 19th Annual American Conference for the Treatment of HIV, focusing on excess visceral abdominal fat (EVAF) in people with HIV (PWH) [1][2][3] VAMOS Analysis - The VAMOS study revealed that EVAF is linked to reduced muscle quality in aging PWH, with a prevalence of 58% among 170 participants [5] - Muscle quality declines with age (r= -0.465; p<0.0001) but is not significantly correlated with body mass index (BMI) (r= -0.118; p=0.124) [5] - Increased visceral fat correlates strongly with lower skeletal muscle quality (r= -0.445; p<0.0001), suggesting it may exacerbate age-related functional decline [5] Tesamorelin/GLP-1 RA Case Series - A case series demonstrated the effectiveness of combining tesamorelin and GLP-1 receptor agonists (RAs) in treating EVAF in PWH, with a mean waist circumference reduction of 1.3 inches [7] - After at least six months of combination therapy, patients experienced mean reductions in weight (-13 pounds), BMI (-2.2 kg/m²), and waist circumference (-3.4 inches), with six out of seven patients meeting their metabolic and body composition goals [7] - This is the first report of dual use of tesamorelin and GLP-1 RAs in PWH, highlighting their complementary mechanisms [7][8]

Core Insights - Theratechnologies Inc. presented data indicating the limitations of using body mass index (BMI) alone for assessing cardiovascular (CV) risk in people with HIV (PWH), emphasizing the need for screening excess visceral abdominal fat (EVAF) to better identify at-risk individuals [1][2][3] Group 1: Study Findings - The VAMOS study characterized BMI as a poor independent surrogate for excess visceral adiposity and CV risk in PWH, particularly highlighting high CV risk in participants with normal or overweight BMI but high levels of EVAF [2][3] - The study involved 170 PWH who had achieved virological suppression on antiretroviral therapy (ART) for at least one year, comparing 10-year atherosclerotic cardiovascular disease (ASCVD) risk scores across different BMI categories [3][4] - Obese individuals (BMI 30-34.9 kg/m2) had the highest prevalence of EVAF at 88%, while 43% of PWH with normal BMI (20-25 kg/m2) and 47% of those classified as overweight (BMI 25-29.9 kg/m2) also exhibited EVAF [3][4] Group 2: Clinical Implications - PWH with EVAF had significantly higher 10-year ASCVD risk scores compared to those without EVAF, regardless of BMI, indicating the importance of considering EVAF in risk assessments [4][5] - The findings suggest that healthcare providers focusing solely on BMI may overlook a significant population of normal-weight and overweight individuals with HIV who are at risk due to EVAF [5] - The study advocates for the use of simple and more precise tools, such as waist circumference measurement, to identify PWH at risk of cardiovascular disease [5]