In the case of the majority of studied drugs , an increased absorption rate was observed early after RYGBP .
The effect on systemic exposure allows for a low degree of extrapolation , including between drugs subjected to the same major metabolic and transporter pathways .
Anatomical changes in the gastrointestinal tract and subsequent weight loss may influence drug disposition and thus drug dosing following bariatric surgery .
This review systematic ally examines the effects of bariatric surgery on drug pharmacokinetics , focusing especially on the mechanisms involved in restricting oral bioavailability .
Sleeve Gastrectomy in Morbidly Obese HIV Patients: Focus on Anti-retroviral Treatment Absorption After Surgery
Context Anti-retroviral therapy ( ART ) dramatically reduced AIDS development , thus enabling patients to live as long as the general population . New challenges have emerged particularly cardiometabolic diseases and weight gain , with some HIV patients seeking bariatric surgery ( BS ) . However , BS outcomes during HIV remain poorly described , with scarce data on ART pharmacokinetic post-BS . Objective Describing sleeve gastrectomy  ( SG ) results in HIV patients in terms of ART pharmacokinetic , HIV control , weight loss , and metabolic outcomes . Design , Setting , and Patients Prospect i ve study of HIV patients undergoing SG in a referral academic center , with at least 6 months follow-up . Main Outcome Measure Clinical and biological parameters , HIV medical history , and ART pharmacokinetics were gathered before and post-SG . Results Seventeen patients ( mean BMI = 44.2 ± 5.7 kg m−2 ) and major obesity-related diseases ( 47 % type-2 diabetes , 64 % obstructive sleep apnea , 70 % hypertension ) underwent SG during a mean 2 years of follow-up . They displayed an average of 20 % reduction of initial BMI and improved body composition , similarly to obese non-HIV patients . SG improved metabolic status . All patients had undetectable viral load before BS . Upon HIV follow-up , 12 patients had undetectable viral load with correct ART kinetic parameters ( 3 and 6 months ) ; 4 displayed detectable viral load along with significant decrease in raltegravir and atazanavir treatment exposure , leading to ART change with subsequent undetectable viral load ; and 1 had persistent detectable viral load despite ART change . Conclusions SG seems effective and safe in obese HIV patients . However , ART treatment should be monitored post-SG to control HIV infection . We suggest that some ART should be adapted before SG conjoints with infectious disease specialists
In the case of the majority of studied drugs , an increased absorption rate was observed early after RYGBP .
The effect on systemic exposure allows for a low degree of extrapolation , including between drugs subjected to the same major metabolic and transporter pathways .
Anatomical changes in the gastrointestinal tract and subsequent weight loss may influence drug disposition and thus drug dosing following bariatric surgery .
This review systematic ally examines the effects of bariatric surgery on drug pharmacokinetics , focusing especially on the mechanisms involved in restricting oral bioavailability .