title: Outcomes of bariatric surgery in human immunodeficiency virus positive individuals: a single center experience.
abstract: 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.
authors.affiliation: Department of Surgery, Chelsea and Westminster Hospital, London, UK - m.alfa-wali@imperial.ac.uk.
authors.forename: Maryam
authors.initials: M
authors.lastname: Alfa-Wali
authors.forename: Shivshankar
authors.initials: S
authors.lastname: Seechurn
authors.forename: Olubaniyi
authors.initials: O
authors.lastname: Ayodeji
authors.forename: Mark
authors.initials: M
authors.lastname: Nelson
authors.forename: Omair
authors.initials: O
authors.lastname: Shariq
authors.forename: Marialessia
authors.initials: M
authors.lastname: Milella
authors.forename: Jeremy
authors.initials: J
authors.lastname: Thompson
authors.forename: Moses
authors.initials: M
authors.lastname: Kapembwa
mesh_terms: D000328:Adult; D000368:Aged; D050110:Bariatric Surgery / Q000379:methods; D015992:Body Mass Index; D015331:Cohort Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss