Aydemir Ceren, Al Saidi Raniah, Choi Ji Soo, Ahmed Mohamed H, Mital Dushyant
Faculty of Medicine and Health Sciences, University of Buckingham, UK.
Department of Medicine, Milton Keynes University Hospital NHS Foundation Trust, Eaglestone, Milton Keynes, Buckinghamshire, UK.
J Family Med Prim Care. 2024 Dec;13(12):5920-5923. doi: 10.4103/jfmpc.jfmpc_730_24. Epub 2024 Dec 9.
We report a case of a 49-year-old female with a history of HIV infection for 12 years. The patient had excellent compliance with antiretroviral medications, raltegravir 400 mg twice daily and truvada once daily for HIV. Over the years, she maintained an undetectable viral load with a CD4+ count >200 cells/μL. She has a history of type II diabetes, hypertension, bipolar manic depression, endometriosis, recurrent herpes simplex attacks, arthritis in both shoulders, irritable bowel syndrome (IBS), and nonalcoholic fatty liver disease (NAFLD). She weighed 148 kg with a body mass index (BMI) of 52.08 kg/m. Her medication included diltiazem 60 mg once a day, glyceryl trinitrate (GTN) spray, metformin 1 g twice daily, and linagliptin 500 mg once daily for her type II diabetes with glycated hemoglobin (HbA1c) of 8.4%. She has full capacity and elected to have bariatric surgery; 4 months postprocedure, she lost 28 kg with a reduced BMI of 38.62 kg/m with no postoperative complications. Her diabetes control improved, and she no longer required linagliptin and metformin. Following the procedure, she was given supplements including ferrous sulfate, vitamin B12, vitamin D, and calcium. She was also prescribed lansoprazole. The case illustrates that bariatric surgery is an effective and safe operation for people living with HIV. Due to complex needs and the need for regular follow-up; primary care, family, and HIV physicians can all collaborate in the care of individuals living with HIV and who underwent bariatric surgery.
我们报告一例49岁女性，有12年HIV感染史。该患者对抗逆转录病毒药物依从性良好，服用拉替拉韦400毫克，每日两次，替诺福韦酯/恩曲他滨复方制剂每日一次用于治疗HIV。多年来，她的病毒载量检测不到，CD4+细胞计数>200个/微升。她有II型糖尿病、高血压、双相躁狂抑郁症、子宫内膜异位症、复发性单纯疱疹发作、双肩关节炎、肠易激综合征（IBS）和非酒精性脂肪性肝病（NAFLD）病史。她体重148公斤，体重指数（BMI）为52.08公斤/平方米。她的药物治疗包括每日一次服用60毫克地尔硫䓬、硝酸甘油（GTN）喷雾剂、每日两次服用1克二甲双胍以及每日一次服用500毫克利格列汀用于治疗II型糖尿病，糖化血红蛋白（HbA1c）为8.4%。她具备完全行为能力，选择接受减肥手术；术后4个月，她体重减轻了28公斤，BMI降至38.62公斤/平方米，无术后并发症。她的糖尿病得到改善，不再需要利格列汀和二甲双胍。手术后，她接受了包括硫酸亚铁、维生素B12、维生素D和钙在内的补充剂。她还被开了兰索拉唑。该病例表明，减肥手术对HIV感染者是一种有效且安全的手术。由于需求复杂且需要定期随访，初级保健医生、家庭医生和HIV专科医生都可以共同协作，为接受减肥手术的HIV感染者提供护理。
