Efficacy and Safety of Bariatric Surgery in Dutch People Living with HIV: a Retrospective Matched Cohort Analysis

• Published in: Obesity surgery 2024-05, Vol.34 (5), p.1584-1589
• Main Authors: Zino, Leena, Qing Chen, Rou, Deden, Laura, Hazebroek, Eric, Richel, Olivier, Colbers, Angela, Burger, David M
• Format: Article
• Language: English
• Subjects: Cohort analysis; Gastrointestinal surgery; HIV; Human immunodeficiency virus; Medicine; Medicine & Public Health; Metabolic disorders; Original Contributions; Surgery; Surgical outcomes; Weight control
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-024-07126-3

Purpose Obesity is rising among people with HIV (PLWH), sparking interest in bariatric surgery (BS) for this group. Yet, large-scale comparative research on BS outcomes in PLWH is lacking. Methods We performed a retrospective, matched cohort analysis in PLWH and HIV uninfected controls. Subjects were retrieved from the Dutch Audit for Treatment of Obesity (DATO) registry. Matching (1:7 ratio) included age (± 5-years), sex, body-mass index (BMI) of ± 3 kg/m 2 , surgery type, and associated health problems (AHPs) at baseline. The primary endpoint was total weight loss percentage (%TWL) ≥ 20% achieved at 1-year post-BS. Secondary endpoints were cumulative %TWL achieved at 2-years post-BS, a reported remission or improvement in AHPs post-BS, and surgical complications, both at 1-year post-BS. Comparisons were performed using conditional logistic regression. Results Twenty-seven PLWH and 168 controls were included. At 1-year post-BS, 89% PLWH achieved ≥ 20%TWL, compared to 94% of controls ( p  = 0.4). Cumulative %TWL at 2-years post-BS were 82% and 92% in PLWH and controls, respectively ( p  = 0.2). Improvement rates in hypertension and type 2 diabetes mellitus were 50% and 86% in PLWH, versus 87% and 87% in controls. Full remission occurred in 20% and 71% of PLHIV, versus 49% and 44% of controls, respectively. No improvement or remission was observed for dyslipidaemia in PLHIV compared to 54% improvement and 29% remission in controls. Surgical complications were 0% in PLHIV and 13% ( n  = 21) in controls. Conclusion Efficacy and safety outcomes of BS were similar between PLWH and controls except for the lack of improvement in dyslipidaemia in PLWH. Graphical abstract