title: Acute pancreatitis in HIV-infected patients: are etiologies changing since the introduction of protease inhibitor therapy?
abstract: BACKGROUND
  Hypertriglyceridemia is a well-established cause of acute pancreatitis in the general population. Protease inhibitor (PI) therapy, introduced in 1996 for HIV infection, is associated with moderate to severe hypertriglyceridemia.
  
  
  OBJECTIVE
  To determine whether the prevalence of hyperlipidemic pancreatitis in HIV-infected patients has increased since the introduction of PIs.
  
  
  METHODS
  This was a retrospective study of patients with acute pancreatitis and HIV infection admitted to three local hospitals between 1990 and 2001.
  
  
  RESULTS
  Before PIs became available (1990-1995), 30 index cases of acute pancreatitis in the setting of HIV infection were identified, and one of these cases (3.3%) was attributed to hypertriglyceridemia. After the introduction of PIs (1996-2001), 54 cases of acute pancreatitis in HIV-infected patients were identified, and two of these cases were attributed to hypertriglyceridemia (3.7%; p = 0.6). In both time periods, medication-induced pancreatitis was the most common cause of pancreatitis in HIV-infected patients.
  
  
  CONCLUSIONS
  Despite the well-established association between PIs and hypertriglyceridemia, there was no significant increase in the prevalence of hyperlipidemic pancreatitis in this HIV-infected population after the introduction of PIs. Medication-associated pancreatitis remains the most common cause of acute pancreatitis in the era of potent antiretroviral therapy.
authors.affiliation: University of Colorado Health Sciences Center, Denver, Colorado, USA.
authors.forename: Zachary M
authors.initials: ZM
authors.lastname: Bush
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Kosmiski
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy*; D017320:HIV Protease Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D015228:Hypertriglyceridemia / Q000139:chemically induced / Q000150:complications / Q000453:epidemiology; D008297:Male; D010195:Pancreatitis / Q000150:complications* / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies
chemical_list: D017320:HIV Protease Inhibitors