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Clinical Characteristics and Outcome of Morbidly Obese Bariatric Patients with Concurrent Hepatitis C Viral Infection

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Abstract

Background

Hepatitis C virus (HCV) is an important cause of liver cirrhosis and its complications. The safety and efficacy of bariatric surgery in patients with HCV infection is not clear.

Methods

Charts were reviewed to identify patients with HCV infection before bariatric surgery. Bariatric surgical patients with non-alcoholic steatohepatitis (NASH) and without NASH (non-NASH) were recruited as comparative groups. Demographic variables, perioperative data, follow-up, and HCV-related parameters were extracted and compared.

Results

Forty-seven bariatric patients between 2000 and 2016 that suffered from HCV infection were identified. The mean age and body mass index (BMI) at baseline were 34.5 ± 9.9 years and 40.4 ± 7.7 kg/m2, respectively. The HCV(+) group was associated with female sex, older age, lower BMI, and waist circumference than both NASH and non-NASH groups. Both HCV(+) and NASH groups had higher liver function tests and incidence of metabolic syndrome than non-NASH group. The HCV(+) group had lower uric acid and albumin level than the NASH group. Early major postoperative complication occurred in 1 (2.1%) patient of the HCV(+) group. At follow-up, the mean BMI decreased to 29.1 ± 7.1 kg/m2 and total weight loss was 25% for the HCV(+) group at 5 years after surgery. The weight loss curves were similar between the HCV(+) group and NASH group. During follow-up, no patients died but one patient with HCV(+) developed flare up of hepatitis after gastric bypass. The mean liver transaminase level remained in normal range for the HCV(+) group.

Conclusion

Co-existence of HCV infection does not influence the outcome of bariatric surgery but continued monitoring of the liver function is indicated.

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Funding

This work was supported by grant NSC 90-2314-B-385-001 from the National Science Council, R.O.C.

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Authors and Affiliations

  1. Department of Internal Medicine, Ming-Sheng General Hospital, National Taiwan University, Taipei, Taiwan

    Ming-Lun Han

  2. Department of Integrated Diagnostics & Therapeutics, National Taiwan University Hospital, Taipei, Taiwan

    Ming-Lun Han

  3. Department of Surgery, Ming-Sheng General Hospital, National Taiwan University, Taipei, Taiwan

    Wei-Jei Lee, Jung-Chien Chen, Kong-Han Ser & Shu-Chun Chen

  4. Tauoyan, Republic of China

    Wei-Jei Lee

  5. Department of International Business, Chien Hsin University of Science and Technology, Taoyuan, Taiwan

    Yi-Chih Lee

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  1. Ming-Lun Han
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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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This article does not contain any studies with human participants or animal performed by any of the authors. For this type of study, formal consent is not required. Informed consent does not apply to the submission.

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Han, ML., Lee, WJ., Chen, JC. et al. Clinical Characteristics and Outcome of Morbidly Obese Bariatric Patients with Concurrent Hepatitis C Viral Infection. OBES SURG 29, 828–834 (2019). https://doi.org/10.1007/s11695-018-3615-z

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