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Comparative Outcomes of Bariatric Surgery in Patients With and Without Human Immunodeficiency Virus.

Comparative Outcomes of Bariatric Surgery in Patients With and Without Human Immunodeficiency Virus.
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Sharma G, Strong AT, Boules M, Tu C, Szomstein S, Rosenthal R, Rodriguez J, Taege AJ, Kroh M,


Sharma G, Strong AT, Boules M, Tu C, Szomstein S, Rosenthal R, Rodriguez J, Taege AJ, Kroh M, (click to view)

Sharma G, Strong AT, Boules M, Tu C, Szomstein S, Rosenthal R, Rodriguez J, Taege AJ, Kroh M,

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Obesity surgery 2017 11 10() doi 10.1007/s11695-017-2996-8

Abstract
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.

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