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Title: DG DISPATCH - CDDW: Predictors Of Acute Pancreatitis Similar In HIV Population And Non-HIV Population
URL: http://www.pslgroup.com/dg/18DDEA.htm
Doctor's Guide
March 10, 2000


By Louise Gagnon
Special to DG News

QUEBEC CITY, QC -- March 10, 200 -- Predictors of severity in acute pancreatitis (AP) are similar in patients with HIV and those not infected with HIV, according to research presented here at the 39th annual meeting of the Canadian Association of Gastroenterology.

"We found that HIV-infected patients also suffered from pancreatitis, usually associated with an opportunistic infection like Kaposi's sarcoma," said Dr. Ian Gan, a resident in internal medicine at St. Paul's Hospital in Vancouver and principal researcher. "We wanted to explore if the same predictors of severity that apply to a non-HIV population could be applied to an HIV-positive population." Dr. Gan presented these findings at Canadian Digestive Diseases Week, in Quebec City, QC, being held March 9-12.

A total of 73 male patients, who had developed HIV between January 1985 and June 1999, were studied retrospectively. Of those, 63 had AIDS, defined as having a CD4 cell count of less than 200 or having an opportunistic infection. The etiology of pancreatitis was found to be commonly linked to consumption of medications (43 percent), idiopathic (25 percent), or alcohol-related (19 percent). A total of 11(15 percent) patients had a severe course of pancreatitis.

Severity of disease was defined as patients requiring admission to an intensive care unit, experiencing local complications, or dying. There were a total of five deaths.

"It has been suspected that HIV patients are developing (acute) pancreatitis with increasing severity because of medications they are taking," said Dr. Gan. "The rate is dropping because some of those medications are being prescribed with less frequency."

Factors such as CD4 count, presence of AIDS, and years since HIV diagnosis failed to show any predictive value, noted Dr. Gan.

To rate severity of disease, the researchers used several scoring systems, including Ranson criteria, the Modified Glasgow score, and APACHE II. The most robust indicator of severity was the APACHE II scoring system, which had an 80 percent specificity rate and an 80 percent sensitivity rate.

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