HIV positive vs. HIV negative acute pancreatitis: etiology, severity and outcomes in the post ARV era.

Abstract

Background: HIV positivity and antiretroviral (ARV) treatment have been described as significant causes of acute pancreatitis (AP) prevalence and predictors of poor outcomes. This data is prior to the universal roll out of ARVs and newer agents. This study assessed if there is still a significant difference between HIV positive (HIV+) and negative(HIV-) patients in AP. Methods: A retrospective review of a prospectively collected clinical database. Results: HIV status was known in 110 patients, 35 HIV+ and 75 HIV-. There were no significant differences in age, gender or race. Median BMI was 24 (HIV+ vs. HIV- p=0.65) Predominant etiology was alcohol (48.1%) and gallstones (33.3%) (HIV+ vs. HIV- p=0.62). ARV’s were not a significant etiology in HIV+ patients. Admission modified Marshall score showed organ failure in 33.8% , 34.8% HIV+ and 33.3% HIV- (p=0.99). Admission median CRP in all patients was 30 , 48 in HIV+ and 24.5 in HIV- (p=0.6). Length of stay did not differ significantly; all patients were 13 (3-166) days; HIV+ 12(3-140) days and HIV- 13 (5-166) days (p=0.40). HIV+ CD4 counts were median 259(3-911), viral load was lower than detectable limits in 3 patients. The treatment status was known on 35 patients, 20 were on ARVs. CD4 count of these patients ranged from 28 to 668. Conclusion: In the present era of ARV treatment there is no significant difference between HIV+ and HIV- patients in the presentation, etiology and outcomes of AP.