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Pancreatic involvement in human immunodeficiency virus infection
1Department of Medicine, Truman Medical Center, Kansas City, Missouri.
Journal of Clinical Gastroenterology
|February 1, 1991
Summary
Human immunodeficiency virus (HIV) infection can affect the pancreas, often asymptomatically. Drug toxicity from HIV medications poses a greater risk for severe pancreatitis than opportunistic infections.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pathology
Background:
- Pancreatic involvement in human immunodeficiency virus (HIV) infection is under-researched.
- Autopsies reveal nonspecific pancreatic changes in HIV patients, not more frequent than in controls.
Purpose of the Study:
- To review the literature on pancreatic involvement in HIV infection.
- To assess the role of opportunistic infections, neoplasms, and drug toxicity in HIV-associated pancreatitis.
Main Methods:
- Systematic review of English language literature.
- Analysis of case reports and pathological findings in HIV-infected patients.
Main Results:
- Disseminated infections (CMV, Cryptococcus, Mycobacteria) and neoplasms (lymphoma, Kaposi's sarcoma) can involve the pancreas in HIV patients.
- Elevated serum amylase is common but often asymptomatic.
- Severe or fatal pancreatitis can occur, particularly linked to drug toxicity from medications like pentamidine and 2',3'-dideoxyinosine.
Conclusions:
- Drug toxicity from HIV treatments warrants greater clinical attention for pancreatitis risk than opportunistic infections or neoplasms.
- While opportunistic infections and neoplasms can affect the pancreas, drug-induced pancreatitis is a significant concern in HIV management.