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September 15, 2004

Severe Acute Pancreatitis

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2004;292(11):1305. doi:10.1001/jama.292.11.1305-b

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

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