Abstract：
BACKGROUND: Selection of an antiretroviral regimen for people living with HIV (PLWH) involves various clinical considerations, such as comorbidities, archived drug resistance mutations, concomitant medications, and potential drug interactions and side effects. Alterations in the surface area and pH of the gastrointestinal tract following bariatric surgery may alter absorption, antiretroviral pharmacokinetics and viral suppression. Data on the efficacy of antiretroviral (ARV) therapy in PLWH who have undergone bariatric surgery are limited or lacking for new antiretrovirals, such as dolutegravir and bictegravir.
METHODS: This case series reports virologic outcomes and side effects in eight cases of PLWH receiving ARV therapy who underwent bariatric surgery. A systematic literature review was performed to review the available literature on the efficacy and safety of antiretroviral regimens in PLWH who have undergone bariatric surgery.
RESULTS: Virologic suppression was not impacted for obese PLWH who underwent bariatric surgery following failure of life-style modifications and pharmacological therapy.
CONCLUSIONS: There were no deleterious effects on HIV progression for PLWH that underwent bariatric surgery. More prospective research is required to validate the effects of bariatric surgery on immunologic and virologic function outcomes. Close involvement of HIV and surgical specialists is recommended to manage ARV therapy in patients undergoing bariatric surgery.
METHODS: This case series reports virologic outcomes and side effects in eight cases of PLWH receiving ARV therapy who underwent bariatric surgery. A systematic literature review was performed to review the available literature on the efficacy and safety of antiretroviral regimens in PLWH who have undergone bariatric surgery.
RESULTS: Virologic suppression was not impacted for obese PLWH who underwent bariatric surgery following failure of life-style modifications and pharmacological therapy.
CONCLUSIONS: There were no deleterious effects on HIV progression for PLWH that underwent bariatric surgery. More prospective research is required to validate the effects of bariatric surgery on immunologic and virologic function outcomes. Close involvement of HIV and surgical specialists is recommended to manage ARV therapy in patients undergoing bariatric surgery.
摘要：
背景：为HIV感染者（PLWH）选择抗逆转录病毒方案涉及各种临床考虑因素，如合并症，存档的耐药突变，合并用药,以及潜在的药物相互作用和副作用。减肥手术后胃肠道表面积和pH值的改变可能会改变吸收，抗逆转录病毒药代动力学和病毒抑制。在接受减肥手术的PLWH中抗逆转录病毒（ARV）治疗的疗效数据有限或缺乏新的抗逆转录病毒药物，如dolutegravir和bictegravir。
方法：本病例系列报告8例接受ARV治疗的PLWH患者接受减肥手术的病毒学结果和副作用。进行了系统的文献综述，以回顾有关抗逆转录病毒疗法在接受减肥手术的PLWH中的疗效和安全性的现有文献。
结果：对于因改变生活方式和药物治疗失败而接受减肥手术的肥胖PLWH，病毒学抑制没有受到影响。
结论：接受减肥手术的PLWH对HIV进展没有有害影响。需要更多的前瞻性研究来验证减肥手术对免疫和病毒学功能结果的影响。建议HIV和外科专家密切参与，以管理接受减肥手术的患者的ARV治疗。
方法：本病例系列报告8例接受ARV治疗的PLWH患者接受减肥手术的病毒学结果和副作用。进行了系统的文献综述，以回顾有关抗逆转录病毒疗法在接受减肥手术的PLWH中的疗效和安全性的现有文献。
结果：对于因改变生活方式和药物治疗失败而接受减肥手术的肥胖PLWH，病毒学抑制没有受到影响。
结论：接受减肥手术的PLWH对HIV进展没有有害影响。需要更多的前瞻性研究来验证减肥手术对免疫和病毒学功能结果的影响。建议HIV和外科专家密切参与，以管理接受减肥手术的患者的ARV治疗。
