Letters Section Editor: Robert M. Golub,
MD, Senior Editor.
To the Editor: Human immunodeficiency virus
(HIV)-AIDS should be noted when considering recent trends in acute pancreatitis.
In patients with AIDS, pancreatitis is 35 to 800 times more common than the
annual incidence of 170 cases per million in the United States.1 Patients
infected with HIV appear to be at extremely high risk for acute pancreatitis
for several reasons. They are vulnerable to direct toxicity to pancreatic
acinar cells from several medications that are frequently used in treatment.
Didanosine, pentamidine, pentavalent antimony, sulfonamides, corticosteroids,
and octreotide have definite association and zalcitabine has probable association
with pancreatitis. Infections due to cytomegalovirus, Toxoplasma
gondii, Mycobacterium avium intracellulare, Mycobacterium tuberculosis, and cryptosporidium are other
causes for acute pancreatitis in this population.1
Kashyap AS, Anand KP, Kashyap S. Severe Acute Pancreatitis. JAMA. 2004;292(11):1305. doi:10.1001/jama.292.11.1305-b