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Erschienen in:
10.11.2017 | Original Contributions
Comparative Outcomes of Bariatric Surgery in Patients With and Without Human Immunodeficiency Virus
Erschienen in: Obesity Surgery | Ausgabe 4/2018
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Background
Paradoxically, advances in anti-retroviral therapy that has increased survival for patients with human immunodeficiency virus (HIV) have resulted in greater numbers of HIV+ patients developing other chronic diseases, including obesity. Little comparative literature exists detailing perioperative or metabolic outcomes of bariatric surgery in the HIV+ population compared to HIV negative (HIV−) controls.
Methods
This is a retrospective case-control study with both HIV+ (case) and HIV− control patients. Individuals undergoing sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) between January 1, 2006 and December 31, 2015 were included. HIV+ status was defined as any individual with documented history of HIV.
Results
Eleven HIV+ patients underwent RYGB or SG during the study period. After matching (1:5 HIV+: HIV−) both cohorts had similar mean age (42 years), gender distribution (63% female), and preoperative BMI (48 kg/m2), as well as comorbidities. There were no differences in postoperative length of stay, or all cause 30-day morbidity. There were 63.7% HIV+ and 76.4% with 1-year follow-up available. Both percent excess weight loss (56% HIV+ vs. 60% HIV−) and BMI (32 HIV+ vs. 34 kg/m2 HIV−) were similar in both groups. There were minimal changes to CD4 count or HIV viral load in the patients during the follow-up period.
Conclusion
Bariatric surgery is safe and feasible in HIV-infected population well controlled on anti-retroviral medication. The short-term surgical and metabolic outcomes are similar to HIV− controls with minimal effect on the CD4 count and viral load in HIV+ cohort for long-term follow-up.