title: Frequency of Pancreatic Hyperamylasemia in Human Immunodeficiency Virus-Positive Patients in the Highly Active Antiretroviral Therapy Era.
abstract: OBJECTIVE
  Increased frequency of hyperamylasemia has previously been reported in human immunodeficiency virus (HIV)-positive patients, but studies determined total amylase activity and were performed before the introduction of highly active antiretroviral therapy (HAART). We evaluated the frequency of pancreatic hyperamylasemia in a large HIV+ population mostly treated with HAART.
  
  
  METHODS
  The upper reference limit (URL) for pancreatic amylase (P-AMY) was derived from 299 healthy blood donors. A cross-sectional study was then performed on samples obtained from 1,548 consecutive patients referred to our infectious disease clinic to assess serum P-AMY and lipase concentrations. Of the patients, 94% were HIV+, and most (92%) were taking HAART (HIV+Tx+).
  
  
  RESULTS
  P-AMY URL was 51 U/L. The frequency of P-AMY increase did not significantly differ between HIV+ and HIV - populations (14.2% vs 15.2%, P = .91) or between HIV+Tx+ and HIV+Tx - (14.7% vs 8.9%, P = .11). In almost half (48.3% of HIV+ and 42.9% of HIV -) of hyperamylasemic patients, lipase was normal, indicating a non pancreatic origin of their P-AMY increase. Markedly elevated P-AMY (>3 times the URL) was found in six HIV+ patients and in one HIV - patient: two had macroamylasemia, one acute pancreatitis, three (including the HIV - patient) chronic pancreatitis, and one chronic hyperamylasemia of undefined origin.
  
  
  CONCLUSIONS
  In our study, both HIV+ and HIV+Tx+ do not show an increased frequency of P-AMY elevation. Frank pancreatic disease is rare in this clinical setting.
authors.affiliation: From the Clinical Pathology Unit, szoke.dominika@hsacco.it.
authors.forename: Dominika
authors.initials: D
authors.lastname: Szőke
authors.affiliation: Department of Infectious Diseases, "Luigi Sacco" University Hospital, Milan, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Ridolfo
authors.affiliation: From the Clinical Pathology Unit.
authors.forename: Cristina
authors.initials: C
authors.lastname: Valente
authors.affiliation: Department of Infectious Diseases, "Luigi Sacco" University Hospital, Milan, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Galli
authors.affiliation: From the Clinical Pathology Unit.
authors.forename: Mauro
authors.initials: M
authors.lastname: Panteghini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood; D023241:Antiretroviral Therapy, Highly Active; D003430:Cross-Sectional Studies; D005260:Female; D006679:HIV Seropositivity / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology*; D006801:Humans; D034321:Hyperamylasemia / Q000097:blood / Q000453:epidemiology*; D008049:Lipase / Q000097:blood; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000453:epidemiology*; D015995:Prevalence; D055815:Young Adult
chemical_list: D008049:Lipase; D000681:Amylases
keywords: HIV; Highly active antiretroviral therapy (HAART); Pancreatic hyperamylasemia