Tesamorelin and liver fat: what the trials show
Two randomised trials in HIV, registry-only data without HIV, and what neither shows.
Checked 2026-10-22 Researched and written by Kymata Health Editorial · Sources cited inline Report an error
Short answer
In adults with HIV and fatty liver, 12 months of tesamorelin cut liver fat by 4.1 points more than placebo, a 37% relative drop, and fewer people's fibrosis progressed. Existing fibrosis did not improve. A trial in people without HIV has posted registry results but no paper. Tesamorelin has no label for fatty liver.
What did the HIV liver-fat trials find?
In 50 adults with HIV and abdominal fat gain, liver fat fell relative to placebo over 6 months, with a net effect of −2.9 points in the lipid-to-water ratio (Stanley 2014, JAMA).
In 61 adults with HIV and fatty liver over 12 months, liver fat fell 4.1 points more than on placebo (−37% relative), 35% vs 4% reached a liver-fat fraction under 5%, and fibrosis progressed in 10.5% vs 37.5%. Existing fibrosis did not improve, and two people on tesamorelin stopped for worsening blood sugar (Stanley 2019, Lancet HIV).
Is there evidence without HIV?
A 12-month trial of the 1.4 mg formulation in people without HIV has posted results on ClinicalTrials.gov: median liver-fat change −5.3% vs +3.6% on placebo. No journal paper had appeared by 2026-10-22 (NCT03375788 (registry results)). Separately, in 60 obese adults with low GH secretion, visceral fat fell with glucose unchanged (Makimura 2012, JCEM).
What do these trials not show?
They measured liver fat by imaging and fibrosis on biopsy over a year; none tested liver outcomes such as cirrhosis or transplant. Tesamorelin's US label covers excess abdominal fat in adults with HIV, not fatty liver disease (Egrifta WR label).
Frequently asked questions
Questions
- Did weight change?
- Not meaningfully: the label notes tesamorelin is weight-neutral, and the fat changes were in the abdomen and liver.
Not medical advice This page summarises published labels and studies. It is not a recommendation to use any product; a clinician decides.