Acute pancreatitis in HIV-infected patients: are etiologies changing since the introduction of protease inhibitor therapy?
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.
Bush
Zachary M
ZM
University of Colorado Health Sciences Center, Denver, Colorado, USA.
Kosmiski
Lisa A
LA
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
D017320:HIV Protease Inhibitors