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. 2022 Jun 1;90(2):240-248.
doi: 10.1097/QAI.0000000000002939.

Comparison of HIV-Infected and Noninfected Patients Undergoing Bariatric Surgery: The ObeVIH Study

V Pourcher  1   2 , J Capeau  3 , Y Dudoit  1 , F Boccara  3   4 , C Soulié  2   5 , A L Ndoadoumgue  2 , F Charlotte  6 , S Fellahi  3   7 , J P Bastard  3   7 , V Béréziat  3 , C Lagathu  3 , A G Marcelin  2   5 , G Peytavin  8 , M C Boutron-Ruault  1   9 , C Tubbax  9 , A D'Avout D'Auerstaedt  9 , M A Valantin  1   2 , L Schneider  1   2 , D Costagliola  2 , C Katlama  1   2 , L Assoumou  2 , G Pourcher  9   10
Affiliations

Comparison of HIV-Infected and Noninfected Patients Undergoing Bariatric Surgery: The ObeVIH Study

V Pourcher et al. J Acquir Immune Defic Syndr. .

Abstract

Objective: The aim of this study was to compare clinical characteristics and adipose/liver tissue histology analysis in HIV-infected and HIV-uninfected subjects undergoing bariatric surgery.

Design: This was a cross-sectional study of HIV-infected subjects undergoing single-port sleeve gastrectomy with prospective enrolment and frequency age (±5 years), sex, and body mass index (BMI, ± 5 kg/m2) matched on HIV-uninfected subjects.

Methods: This study was conducted at a single clinical site at Pitié-Salpêtrière hospital-Paris-France comprising 19 HIV-uninfected and 21 HIV-infected subjects with plasma VL < 20 copies/mL, all with a BMI > 40 kg/m2 or >35 kg/m2 with comorbidities. Histology of subcutaneous and visceral abdominal adipose tissue (SCAT/VAT) and liver biopsies was collected during single-port sleeve gastrectomy. Outcomes included anthropometric characteristics, comorbidities, cardiovascular parameters, adipose tissue, and liver histology.

Results: The age of HIV-infected participants was (median, interquartile range IQR) 48 y (42-51), with 76.2% females, a BMI of 41.4 kg/m2 (37.3-44.4), an antiretroviral duration of 16 y (8-21), current integrase strand transfer inhibitor (INSTI)-based regimen in 15 participants and non-INSTI regimen in 6 participants, and a CD4 count of 864/mm3 (560-1066). The age of controls was 43 y (37-51), with 78.9% females and a BMI of 39.2 kg/m2 (36.3-42.6). Anthropometric characteristics, comorbidities, and cardiovascular parameters did not differ according to HIV status and INSTI treatment. The number of macrophage crown-like structures in SCAT was lower in INSTI-treated participants than in HIV-uninfected participants (P = 0.02) and non-INSTI-treated HIV-infected subjects (P = 0.07). Hepatic steatosis and liver disease severity global score were lower in INSTI-treated participants than in non-INSTI-treated HIV-infected participants (P = 0.05 and P = 0.04, respectively).

Conclusions: HIV-infected and HIV-uninfected subjects undergoing bariatric surgery presented a similar profile regarding anthropometric measures, cardiovascular parameters, and comorbidities. However, INSTI-treated participants presented milder SCAT and liver alterations than non-INSTI-treated participants.

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Conflict of interest statement

This study was funded in part by ANRS (ECTZ121032). V.P. reports lecture fees from Gilead, ViiV, MSD, Roche, Biogen, and Merck Serono outside the submitted work. J.C. reports grants paid to the institution from ViiV healthcare and MSD and lecture fees from Gilead, ViiV Healthcare, MSD, and Janssen outside the submitted work. C.L. reports lecture fees from MSD outside the submitted work. F.B. reports research grants from Amgen and lecture fees from Gilead, ViiV Healthcare, Amgen, Sanofi, MSD, and Servier outside the submitted work. M.C.B.R. reports lecture fees from Gilead and Mayoli-Spindler outside the submitted work. D.C. reports HIV grants from Janssen (2017–2018 and 2019–2020) and personal fees from Janssen (2018) and Gilead (2018 and 2020) for lectures on HIV outside the submitted work. The remaining authors have no funding or conflicts of interest to disclose.

References

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