Safety of bariatric surgery in HIV-positive patients on antiretroviral therapy.

BACKGROUND

Obesity among people living with HIV (PLWH) is rising, but the safety of bariatric surgery in this population remains unclear. Preliminary evidence suggests that bariatric surgery does not exacerbate HIV progression or elevate postoperative risk.

OBJECTIVES

This study aimed to compare the risk of all-cause mortality and inpatient admission between HIV-positive and HIV-negative patients undergoing bariatric surgery. Secondary aims included evaluating adverse events (sepsis, obstruction, pancreatitis, etc.) during the 5 years postsurgery.

SETTING

Global, multicenter.

METHODS

Using the TriNetX multi-institutional research database, we identified patients who underwent bariatric surgery, including 503 HIV-positive individuals who were prescribed antiretroviral therapy (ART) and 129,150 HIV-negative individuals. Propensity score matching was conducted to reduce confounding. Safety was assessed through time-to-event analyses for primary and secondary outcomes. Sensitivity analyses were performed to validate the findings.

RESULTS

No significant differences were observed in time-to-event analyses for mortality (P = .27) or inpatient admission (P = .46). Adverse health outcomes were comparable between cohorts, even in sensitivity analyses (all P > .05).

CONCLUSION

To our knowledge, this is the largest retrospective analysis to date examining bariatric surgery outcomes in HIV-positive patients prescribed ART. Results indicate that bariatric surgery is safe in this population, supporting its use as a viable intervention for obesity management among PLWH.