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Published on: November 14, 2020
HIV Infection Is Not a Contraindication to Laparoscopic Sleeve Gastrectomy for Morbid Obesity
Nancy Panko1, Gerrit Dunford2, Rami Lutfi2
1Presence Saint Joseph Hospital, Chicago, IL, USA. nbpanko@gmail.com.
Background:
The efficacy of antiretroviral therapy has made HIV a chronic condition. The prevalence of obesity in HIV positive patients has subsequently risen and is present in 6-34% of men and 21-30% of women (Keithley et al. J Assoc Nurses AIDS Care 20(4):260-74, 2009). Sleeve gastrectomy is a safe and effective procedure for weight loss in the general population, but having HIV may bring hesitation to performing bariatric surgery for some practitioners.
Objectives:
The aim of this study is to evaluate the safety and efficacy of laparoscopic sleeve gastrectomy (LSG) in patients with HIV.
Methods:
A retrospective analysis of prospectively collected data of patients with HIV who underwent LSG at a community hospital by a single surgeon was performed. Nine patients with HIV underwent LSG. Primary outcomes include weight loss at 6 and 12 months and postoperative CD4 count and viral load. Secondary outcomes include alteration to antiretroviral therapy (ART).
Results:
Our patients had a mean BMI of 46 (range 35-66) and were all well controlled on ART preoperatively. Mean weight loss at 12 months was 40 kg (range 21-55), with mean excess body weight loss 69% (range 42-112). There were no significant changes in CD4 counts, and all patients continued to have undetectable viral loads at 1 year postoperatively. One patient had a change in ART, which was unrelated to bariatric surgery. There were no complications in our patient group.
Conclusion:
This is the largest series to date evaluating sleeve gastrectomy in HIV-positive patients and further supports the safety and efficacy of sleeve gastrectomy in this patient population.
