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Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,877
Online ISSN 1827-1626
Maryam ALFA-WALI 1, Shivshankar SEECHURN 2, Olubaniyi AYODEJI 2, Mark NELSON 1, Omair SHARIQ 1, Marialessia MILELLA 1, Jeremy THOMPSON 1, Moses KAPEMBWA 2
1 Department of Surgery, Chelsea and Westminster Hospital, London, UK; 2 Department of Sexual Health, Northwick Park Hospital, Harrow, UK
BACKGROUND: Obesity is a global pandemic that is also affecting HIV-positive individuals receiving combined anti-retroviral therapy. We present the outcomes of a cohort of HIV-positive individuals who underwent bariatric surgery in a single centre. The primary outcome was weight loss including secondary end points such as the use of hypoglycaemic and/or anti-hypertensive medication.
METHODS: An electronic hospital database was used to retrospectively identify individuals that were HIV-positive and had bariatric surgery between 2003 and 2013. Detailed morphometric, immunological and virological data including post-operative follow-up information were obtained from the database.
RESULTS: Twelve HIV-positive individuals (male =8, female =4) underwent bariatric surgery following multi-disciplinary team meetings and engagement in the pre-operative bariatric surgery care pathway. Their mean age was 46 years (range 33-66) with a median BMI of 43 kg/m2 (range 37-55). The mean duration of HIV prior to surgery was six years (range 3-24). All procedures were performed laparoscopically and included gastric banding (N.=8), sleeve gastrectomy (N.=1), gastric ileo-bypass (N.=1) and a Roux -en –Y gastric bypass (N.=2). Two patients had wound infections related to their gastric bands. Nine patients achieved weight loss and all but one patient remained without anti-hypertensives or anti-diabetic medication.
CONCLUSIONS: Bariatric surgery is safe in stable HIV-positive individuals receiving multiple drug therapies with no detrimental effect on viral suppression. It should therefore be offered as a management strategy for obesity in HIV-positive individuals as per the general population.