Semaglutide's Efficacy in Achieving Weight Loss for Those With HIV

A randomised, controlled, parallel-group, open-label study comparing treatment with the GLP-1 analogue semaglutide in combination with lifestyle interventions to lifestyle interventions alone in obese PWH. The study will enroll HIV-1 infected patients ≥ 18 years with BMI ≥30kg/m2 or BMI ≥27kg/m2 and hypertension, dyslipidaemia or type 2 diabetes mellitus. Primary objective: To assess the efficacy of semaglutide as an adjunct to diet and exercise in achieving greater weight loss in obese PWH as compared to diet and exercise alone. Secondary objectives: * To explore the effect of semaglutide on markers of immune function and HIV viral reservoirs in obese PWH. * To explore the effect of semaglutide on markers of glucose and lipid metabolism in obese PWH. * To explore the effect of semaglutide on markers of inflammation and gut microbial translocation in obese PWH. * To assess the safety of semaglutide in obese PWH on stable ART.