Pancreatitis in a high HIV prevalence environment.

Area of Science:

• Infectious Diseases
• Gastroenterology
• Epidemiology

Background:

• Acute pancreatitis is frequently observed in individuals with human immunodeficiency virus (HIV) infection, especially in regions with low HIV prevalence.
• This association has been less documented in areas characterized by high HIV prevalence.

Purpose of the Study:

• To investigate the prevalence and clinical outcomes of acute pancreatitis in patients with HIV in a high HIV prevalence environment.
• To analyze trends in HIV-associated acute pancreatitis from May 2001 to November 2010.

Main Methods:

• Retrospective review of patients admitted with acute pancreatitis between 2001 and 2010.
• Data collected included HIV status, CD4 counts, and medications. Assessment of Glasgow criteria, organ failure, local complications, and mortality.

Main Results:

• 16.9% of 627 acute pancreatitis patients were HIV-positive, predominantly female (65.1%) and black African (91.5%).
• Alcohol was a less common cause in HIV-positive patients (24.5%) compared to HIV-negative patients (68.3%). Antiretroviral therapy was linked to pancreatitis in 35.8% of cases.
• Pancreatic necrosis occurred in 15.1%, septic complications in 18.9%, and mortality was 5.7% in HIV-positive patients.

Conclusions:

• HIV-associated acute pancreatitis is more common in females and black Africans and may be linked to malignancy.
• Mortality rates for acute pancreatitis were comparable between HIV-positive and HIV-negative individuals.