Incidence of Acute Pancreatitis in Human Immunodeficiency Virus–Positive Patients With Hypertriglyceridemia: Is It Really High?

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Abstract

Objective

To assess the incidence of acute pancreatitis in human immunodeficiency virus–positive patients with triglyceride (TG) greater than 500 mg/dL after highly active antiretroviral therapy.

Methods

Sequential TG levels during follow-up and episodes of acute pancreatitis were retrospectively reviewed in 347, 417, and 571 patients enrolled in periods 1 (2000–2002), 2 (2003–2005), and 3 (2006–2008), respectively. The incidence of acute pancreatitis, defined as consistent clinical symptoms and elevated amylase and/or lipase levels, was estimated.

Results

A total of 5356 TG measurements were performed during the follow-up for 698.22, 884.14, and 1215.69 person-years in periods 1, 2, and 3, respectively. Overall, 9.89% of patients had at least one TG greater than 500 mg/dL. Five patients with TG less than 500 mg/dL developed acute pancreatitis. The crude incidences of acute pancreatitis were 0.6%, 0.5%, and 0.2%, and the incidence rates were 2.86, 2.26, and 0.82/1000 person-years in periods 1, 2 and 3, respectively (all, P > 0.05). The incidence rates of acute pancreatitis when TG levels were less than 500, less than 1000, and less than 1500 mg/dL ranged from 1.2 to 4.9/1000 person-years, whereas it was 0/1000 person-years when TG levels were greater than 500, greater than 1000, and greater than 1500 mg/dL, respectively.

Conclusion

The risk of acute pancreatitis was low among human immunodeficiency virus–positive patients who developed hypertriglyceridemia after receiving highly active antiretroviral therapy.

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