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

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