Predictors of the severity of acute pancreatitis in patients with HIV infection or AIDS

We retrospectively reviewed the charts of 54 human immunodeficiency virus ( HIV) infected patients or acquired immunodeficiency syndrome (AIDS), who we re hospitalized at the Bronx-Lebanon Hospital Center with acute pancreatiti s between January 1993 and December 1995. Nineteen were female and 35 were male patients. Thirty-five (65%) of 54 patients were younger than 40 years (average age, 42 years). Forty-eight (89%) of the patients had a CD4 count of <200 units/ml of blood. Seventeen (32%) patients died either of complica tions of acute pancreatitis or of underlying disease. The conventional prog nostic criteria used to assess the severity of pancreatitis, including Rans on's and Imrie's criteria and the APACHE II system, were applied. We determ ined that these criteria were not appropriate to our HIV/AIDS patients. Onl y serum calcium levels at 48 h after admission and serum creatinine and blo od urea nitrogen (BUN) at admission and at 48 h after admission had signifi cant p values (<0.05). We believe that the predictors commonly used to iden tify the severity of pancreatitis were not useful in these patients because of their low CD4 counts and preexisting liver and renal disease.