Abnormalities of serum amylase and lipase in HIV-positive patients

OBJECTIVE We sought to study asymptomatic pancreatic enzyme abnormalities i n patients with human immunodeficiency virus (HIV) infection. METHODS: Serial serum amylase and lipase determinations were performed in a mbulatory HIV-seropositive patients in whom pancreatitis was not suspected. RESULTS: Eighty-six patients were enrolled in the study. Fifty-two patients (60%) were found to have abnormal amylase or Lipase Values on at: least on e determination. Only 12 (14% of all patients) had a more than twofold elev ation of pancreatic enzymes. Seven patients had transient elevations of lip ase within 3 months after the initiation of antiretroviral therapy. Indepen dent factors associated with abnormal pancreatic enzymes were: positive ser ology for chronic hepatitis B or C, history of intravenous cotrimoxazole ad ministration for the treatment of Pneumocystis carinii pneumonia, stage B o f HIV disease, and HIV risk factors other than male homosexuality (mainly i ntravenous drug use). None of the patients developed clinical pancreatitis. CONCLUSIONS: Asymptomatic mild to moderate elevations of amylase or lipase are common in HIV-positive patients, and are usually associated with positi ve serology for chronic hepatitis B or C, and medications, especially antir etrovirals and intravenous cotrimoxazole. (C) 1999 by Am. Cell. of Gastroen terology.