Pancreatitis in a high HIV prevalence environment
Background. Acute pancreatitis is common in HIV-positive individuals in reports from regions with a low incidence of HIV infection. This association has not been reported in areas with a high incidence of HIV infection. Objective. To examine the prevalence and outcomes of HIV-associated acute pancr...
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| Format: | Article |
| Language: | English |
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South African Medical Association
2017-08-01
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| Series: | South African Medical Journal |
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| Online Access: | http://www.samj.org.za/index.php/samj/article/view/12038/8205 |
| _version_ | 1797329396707622912 |
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| author | Frank Anderson Sandie R Thomson |
| author_facet | Frank Anderson Sandie R Thomson |
| author_sort | Frank Anderson |
| collection | DOAJ |
| description | Background. Acute pancreatitis is common in HIV-positive individuals in reports from regions with a low incidence of HIV infection. This association has not been reported in areas with a high incidence of HIV infection.
Objective. To examine the prevalence and outcomes of HIV-associated acute pancreatitis in a high HIV prevalence environment, and trends over the period May 2001 - November 2010.
Methods. The records of patients admitted with acute pancreatitis from 2001 to 2010 were reviewed, looking for HIV status, CD4 counts and medications at presentation. The Glasgow criteria, organ failure, local complications and mortality were assessed.
Results. One hundred and six (16.9%) of 627 patients admitted with acute pancreatitis during the study period were infected with HIV. Most were female (65.1%) and black African (91.5%). The serum amylase level was used to confirm acute pancreatitis in 50 patients, with a mean of 1 569 IU/L (range 375 - 5 769), and urinary amylase in 56 patients, with a mean of 4 083 IU/L (range 934 - 36 856). Alcohol was a less frequent cause of pancreatitis in the HIV-positive group than in patients who were HIV-negative (24.5% v. 68.3%), and the prevalence of gallstones as a cause was similar (23.6% v. 17.9%). Antiretroviral therapy was associated with pancreatitis in 35.8%, and 6 (5.7%) had abdominal malignancies. Sixteen (15.1%) had pancreatic necrosis, 20 (18.9%) had septic complications, and 6 (5.7%) died.
Conclusions. HIV-associated acute pancreatitis was most frequent in females and black Africans and was associated with malignancy. Mortality was similar in HIV and non-HIV pancreatitis. |
| first_indexed | 2024-03-08T07:04:05Z |
| format | Article |
| id | doaj.art-d00b1701dd0d4926bc38b6a35d873425 |
| institution | Directory Open Access Journal |
| issn | 0256-9574 2078-5135 |
| language | English |
| last_indexed | 2024-03-08T07:04:05Z |
| publishDate | 2017-08-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj.art-d00b1701dd0d4926bc38b6a35d8734252024-02-03T05:06:27ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352017-08-01107870670910.7196/SAMJ.2017.v107i8.10296Pancreatitis in a high HIV prevalence environmentFrank Anderson0Sandie R Thomson1Department of Surgery, Inkosi Albert Luthuli Central Hospital and School of Clinical Medicine, College of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South AfricaDepartment of Gastroenterology, Groote Schuur Hospital and Faculty of Health sciences, University of Cape Town, South AfricaBackground. Acute pancreatitis is common in HIV-positive individuals in reports from regions with a low incidence of HIV infection. This association has not been reported in areas with a high incidence of HIV infection. Objective. To examine the prevalence and outcomes of HIV-associated acute pancreatitis in a high HIV prevalence environment, and trends over the period May 2001 - November 2010. Methods. The records of patients admitted with acute pancreatitis from 2001 to 2010 were reviewed, looking for HIV status, CD4 counts and medications at presentation. The Glasgow criteria, organ failure, local complications and mortality were assessed. Results. One hundred and six (16.9%) of 627 patients admitted with acute pancreatitis during the study period were infected with HIV. Most were female (65.1%) and black African (91.5%). The serum amylase level was used to confirm acute pancreatitis in 50 patients, with a mean of 1 569 IU/L (range 375 - 5 769), and urinary amylase in 56 patients, with a mean of 4 083 IU/L (range 934 - 36 856). Alcohol was a less frequent cause of pancreatitis in the HIV-positive group than in patients who were HIV-negative (24.5% v. 68.3%), and the prevalence of gallstones as a cause was similar (23.6% v. 17.9%). Antiretroviral therapy was associated with pancreatitis in 35.8%, and 6 (5.7%) had abdominal malignancies. Sixteen (15.1%) had pancreatic necrosis, 20 (18.9%) had septic complications, and 6 (5.7%) died. Conclusions. HIV-associated acute pancreatitis was most frequent in females and black Africans and was associated with malignancy. Mortality was similar in HIV and non-HIV pancreatitis.http://www.samj.org.za/index.php/samj/article/view/12038/8205HIVPancreatitis |
| spellingShingle | Frank Anderson Sandie R Thomson Pancreatitis in a high HIV prevalence environment South African Medical Journal HIV Pancreatitis |
| title | Pancreatitis in a high HIV prevalence environment |
| title_full | Pancreatitis in a high HIV prevalence environment |
| title_fullStr | Pancreatitis in a high HIV prevalence environment |
| title_full_unstemmed | Pancreatitis in a high HIV prevalence environment |
| title_short | Pancreatitis in a high HIV prevalence environment |
| title_sort | pancreatitis in a high hiv prevalence environment |
| topic | HIV Pancreatitis |
| url | http://www.samj.org.za/index.php/samj/article/view/12038/8205 |
| work_keys_str_mv | AT frankanderson pancreatitisinahighhivprevalenceenvironment AT sandierthomson pancreatitisinahighhivprevalenceenvironment |