{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T17:55:02Z","timestamp":1794246902212,"version":"4.9.0"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,9]],"date-time":"2025-07-09T00:00:00Z","timestamp":1752019200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Bariatric surgery is a growing treatment for Class 3 obesity in people with HIV, but concerns remain about antiretroviral therapy pharmacokinetics, comorbidities, and mortality. Existing studies confirm safety but are limited by small sample sizes and outdated cohorts. This study utilizes a recent, large U.S. inpatient cohort to address gaps.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a retrospective cohort study using the Nationwide Inpatient Sample from 2015 to 2021, identifying hospitalizations for bariatric surgery among patients with and without HIV. We compared demographics, comorbidities, and hospitalization outcomes between groups. We analyzed in-hospital mortality using Weibull regression and identified independent predictors via multivariable Cox proportional hazards models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 112,348 bariatric surgery hospitalizations, 1,204 (1.1%) were in HIV-positive patients. HIV-positive patients were younger (51.0 vs. 56.1 years;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), predominantly male (72.0% vs. 40.3%;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), and had longer median lengths of stay (14.2 vs. 10.7 days;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). Bariatric surgery rates among HIV-positive patients remained stable from 2017 to 2021 (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.4). Compared with HIV-negative patients, those with HIV had higher prevalences of liver disease (11.7% vs. 1.7%;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), renal disease (12.7% vs. 9.2%;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), and a history of cancer (26.3% vs. 15.7%;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001). In unadjusted Weibull regression, HIV-positive status was associated with better in-hospital survival (\n                      <jats:italic>p<\/jats:italic>\n                      = 0.001), but after adjustment, HIV was not an independent predictor of mortality (HR 0.97;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.843). Independent predictors of mortality across the entire cohort included advancing age (HR 1.04 per year;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), sepsis (HR 3.36;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), and liver disease (HR 1.70;\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Bariatric surgery is safe for HIV-positive patients. Despite stable utilization, disparities persist. Further research is needed to improve access and assess long-term outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11695-025-08007-z","type":"journal-article","created":{"date-parts":[[2025,7,10]],"date-time":"2025-07-10T09:35:17Z","timestamp":1752140117000},"page":"3111-3119","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["In-Hospital Outcomes of Bariatric Surgery in People Living with HIV: A Nationwide Analysis"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7148-5450","authenticated-orcid":false,"given":"Leandro","family":"Sierra","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Aitharaju","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renan","family":"Prado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Cymbal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Chaterjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akash","family":"Khurana","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roma","family":"Patel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Firkins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Simons-Linares","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,9]]},"reference":[{"key":"8007_CR1","doi-asserted-by":"publisher","unstructured":"Fehervari M, Mitra AT, Sargsyan N, et al. Five-year outcomes of bariatric surgery vs. conservative weight management in people with HIV: a single-center tertiary care experience.\u00a0Obes Surg. 2024;34(10):3594-3605.\u00a0https:\/\/doi.org\/10.1007\/s11695-024-07443-7.","DOI":"10.1007\/s11695-024-07443-7"},{"issue":"14","key":"8007_CR2","doi-asserted-by":"publisher","first-page":"1959","DOI":"10.1097\/QAD.0000000000001915","volume":"32","author":"P Sharma","year":"2018","unstructured":"Sharma P, McCarty TR, Ngu JN, et al. Impact of bariatric surgery in patients with HIV infection: a nationwide inpatient sample analysis, 2004\u20132014. AIDS. 2018;32(14):1959\u201365. https:\/\/doi.org\/10.1097\/QAD.0000000000001915.","journal-title":"AIDS"},{"issue":"11","key":"8007_CR3","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1093\/cid\/ciad404","volume":"77","author":"L Zino","year":"2023","unstructured":"Zino L, Wit F, Rokx C, et al. Outcomes of Bariatric Surgery in People With Human Immunodeficiency Virus: A Retrospective Analysis From the ATHENA Cohort. Clin Infect Dis. 2023;77(11):1561\u20138. https:\/\/doi.org\/10.1093\/cid\/ciad404.","journal-title":"Clin Infect Dis"},{"issue":"4","key":"8007_CR4","doi-asserted-by":"publisher","first-page":"1070","DOI":"10.1007\/s11695-017-2996-8","volume":"28","author":"G Sharma","year":"2018","unstructured":"Sharma G, Strong AT, Boules M, et al. Comparative Outcomes of Bariatric Surgery in Patients With and Without Human Immunodeficiency Virus. Obes Surg. 2018;28(4):1070\u20139. https:\/\/doi.org\/10.1007\/s11695-017-2996-8.","journal-title":"Obes Surg"},{"issue":"6","key":"8007_CR5","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1177\/1060028014525034","volume":"48","author":"CE MacBrayne","year":"2014","unstructured":"MacBrayne CE, Blum JD, Kiser JJ. Tenofovir, emtricitabine, and darunavir\/ritonavir pharmacokinetics in an HIV-infected patient after Roux-en-Y gastric bypass surgery. Ann Pharmacother. 2014;48(6):816\u20139. https:\/\/doi.org\/10.1177\/1060028014525034.","journal-title":"Ann Pharmacother"},{"issue":"11","key":"8007_CR6","doi-asserted-by":"publisher","first-page":"855","DOI":"10.1097\/MLR.0000000000001196","volume":"57","author":"M Boudreaux","year":"2019","unstructured":"Boudreaux M, Gangopadhyaya A, Long SK, et al. Using data from the healthcare cost and utilization project for state health policy research. Med Care. 2019;57(11):855\u201360. https:\/\/doi.org\/10.1097\/MLR.0000000000001196.","journal-title":"Med Care"},{"issue":"4","key":"8007_CR7","doi-asserted-by":"publisher","first-page":"667","DOI":"10.1016\/j.soard.2020.12.008","volume":"17","author":"BY Hui","year":"2021","unstructured":"Hui BY, Khorgami Z, Puthoff JS, et al. Postoperative sepsis after primary bariatric surgery: an analysis of MBSAQIP. Surg Obes Relat Dis. 2021;17(4):667\u201372. https:\/\/doi.org\/10.1016\/j.soard.2020.12.008.","journal-title":"Surg Obes Relat Dis"},{"issue":"2","key":"8007_CR8","doi-asserted-by":"publisher","first-page":"73","DOI":"10.1016\/j.soard.2005.02.004","volume":"1","author":"L Flancbaum","year":"2005","unstructured":"Flancbaum L, Drake V, Colarusso T, et al. Initial experience with bariatric surgery in asymptomatic human immunodeficiency virus-infected patients. Surg Obes Relat Dis. 2005;1(2):73\u20136. https:\/\/doi.org\/10.1016\/j.soard.2005.02.004.","journal-title":"Surg Obes Relat Dis"},{"key":"8007_CR9","doi-asserted-by":"publisher","unstructured":"Horberg M, Thompson M, Agwu A, et al. Primary care guidance for providers of care for persons with human immunodeficiency virus: 2024 update by the HIV medicine association of the infectious diseases society of America.\u00a0Clin Infect Dis. Published online October 12, 2024. https:\/\/doi.org\/10.1093\/cid\/ciae479","DOI":"10.1093\/cid\/ciae479"},{"issue":"2","key":"8007_CR10","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1097\/QAD.0000000000003410","volume":"37","author":"MJ Cummings","year":"2023","unstructured":"Cummings MJ, Bakamutumaho B, Price A, et al. HIV infection drives pro-inflammatory immunothrombotic pathway activation and organ dysfunction among adults with sepsis in Uganda. AIDS. 2023;37(2):233\u201345. https:\/\/doi.org\/10.1097\/QAD.0000000000003410.","journal-title":"AIDS"},{"issue":"12","key":"8007_CR11","doi-asserted-by":"publisher","first-page":"1391","DOI":"10.1016\/j.soard.2023.06.007","volume":"19","author":"G Chen","year":"2023","unstructured":"Chen G, Donahoo WT, Cardel MI, et al. Variation by race\/ethnicity in the utilization and weight loss following metabolic bariatric surgery. Surg Obes Relat Dis. 2023;19(12):1391\u2013404. https:\/\/doi.org\/10.1016\/j.soard.2023.06.007.","journal-title":"Surg Obes Relat Dis"},{"key":"8007_CR12","doi-asserted-by":"publisher","unstructured":"Nguyen GC, Patel AM. Racial disparities in mortality in patients undergoing bariatric surgery in the U.S.A.\u00a0Obes Surg. 2013;23(10):1508-1514. https:\/\/doi.org\/10.1007\/s11695-013-0957-4","DOI":"10.1007\/s11695-013-0957-4"},{"issue":"1","key":"8007_CR13","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s11695-022-06333-0","volume":"33","author":"JN Robinson","year":"2023","unstructured":"Robinson JN, Ayuso SA, Thompson KJ, et al. African American Patients Experience Worse Outcomes than Hispanic Patients Following Bariatric Surgery: an Analysis Using the MBSAQIP Data Registry. Obes Surg. 2023;33(1):57\u201367. https:\/\/doi.org\/10.1007\/s11695-022-06333-0.","journal-title":"Obes Surg"},{"issue":"5","key":"8007_CR14","doi-asserted-by":"publisher","first-page":"1523","DOI":"10.1007\/s11695-022-05956-7","volume":"32","author":"EA Kaip","year":"2022","unstructured":"Kaip EA, Nguyen NY, Cocohoba JM. Antiretroviral Therapy Efficacy Post-Bariatric Weight Loss Surgery: A Case Series of Persons Living with Human Immunodeficiency Virus. Obes Surg. 2022;32(5):1523\u201330. https:\/\/doi.org\/10.1007\/s11695-022-05956-7.","journal-title":"Obes Surg"}],"container-title":["Obesity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-025-08007-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11695-025-08007-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-025-08007-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T02:15:58Z","timestamp":1756260958000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11695-025-08007-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,9]]},"references-count":14,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["8007"],"URL":"https:\/\/doi.org\/10.1007\/s11695-025-08007-z","relation":{},"ISSN":["0960-8923","1708-0428"],"issn-type":[{"value":"0960-8923","type":"print"},{"value":"1708-0428","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,9]]},"assertion":[{"value":"22 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 June 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 June 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 July 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Informed consent was not necessary in the present study.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed Consent"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}