Abnormalities of serum amylase and lipase in HIV-positive patients.
OBJECTIVE
We sought to study asymptomatic pancreatic enzyme abnormalities in patients with human immunodeficiency virus (HIV) infection.


METHODS
Serial serum amylase and lipase determinations were performed in ambulatory HIV-seropositive patients in whom pancreatitis was not suspected.


RESULTS
Eighty-six patients were enrolled in the study. Fifty-two patients (60%) were found to have abnormal amylase or lipase values on at least one determination. Only 12 (14% of all patients) had a more than twofold elevation of pancreatic enzymes. Seven patients had transient elevations of lipase within 3 months after the initiation of antiretroviral therapy. Independent factors associated with abnormal pancreatic enzymes were: positive serology for chronic hepatitis B or C, history of intravenous cotrimoxazole administration for the treatment of Pneumocystis carinii pneumonia, stage B of HIV disease, and HIV risk factors other than male homosexuality (mainly intravenous drug use). None of the patients developed clinical pancreatitis.


CONCLUSIONS
Asymptomatic mild to moderate elevations of amylase or lipase are common in HIV-positive patients, and are usually associated with positive serology for chronic hepatitis B or C, and medications, especially antiretrovirals and intravenous cotrimoxazole.
Argiris
A
A
Department of Internal Medicine, Beth Israel Medical Center, New York, New York, USA.
Mathur-Wagh
U
U
Wilets
I
I
Mildvan
D
D
D000328:Adult; D000368:Aged; D000681:Amylases / Q000097:blood*; D000890:Anti-Infective Agents / Q000008:administration & dosage; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000201:enzymology; D006679:HIV Seropositivity / Q000150:complications / Q000201:enzymology*; D006525:Hepatitis, Viral, Human / Q000150:complications; D006716:Homosexuality; D006801:Humans; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000008:administration & dosage
D000890:Anti-Infective Agents; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D008049:Lipase; D000681:Amylases