Bariatric Surgery in Individuals with HIV and Type 2 Diabetes: A Case Series
Principal Investigator(s): View help for Principal Investigator(s) Wei Yang, Chelsea and Westminster Hospital
Version: View help for Version V1
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Project Citation:
Yang, Wei. Bariatric Surgery in Individuals with HIV and Type 2 Diabetes: A Case Series. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2018-07-16. https://doi.org/10.3886/E104725V1
Project Description
Summary:
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Background The efficacy and safety of bariatric surgery have not been fully
elucidated in patients affected with HIV. Although adjustable gastric banding
(ABG) and sleeve gastrectomy (SG) are started to be used in HIV patients, there
are limited descriptions of the outcomes of T2DM in the HIV positive group
undergoing these procedures.
Case presentation We have evaluated retrospectively three patients
who underwent AGB or SG, the effect in weight reduction and glycaemic control as
well as its impact on the HIV management. Case 1 (AGB) achieved 19% total
weight loss (TWL) and Cases 2 and 3 (SG) lost 25% and 14% respectively
post-operation. In terms of T2DM, Case 2 achieved complete remission according
to ADA criteria, while Case 1 would also have achieved remission were it not
for the continuation of metformin postoperatively. Insulin requirements and
pill burden were markedly reduced in Case 3 after SG, though lack of remission
was predictable given the longevity of T2DM and pre-operative insulin dosage.
In all three cases, HIV status did not appear to be affected by the bariatric
surgery which was supported by the post-operative stable CD4 count and
undetectable viral load.
Conclusions Bariatric surgery is a safe and effective treatment
modality in the HIV positive patient with obesity and T2DM.
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