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THE SOUTH AFRICAN GASTROENTEROLOGY REVIEW 2022 | VOLUME 20 | ISSUE 2 | 7 REVIEW Introduction Chronic calcific pancreatitis (CP) is a progressive fibro-inflammatory disease of the pancreas. In its later stages it is characterized by both exocrine dysfunction presenting as malabsorption and steatorrhea, and endocrine dysfunction in the form of diabetes mellitus. Alcohol is the most common risk factor. 1 Other factors include smoking, a genetic predisposition and xenobiotic exposure. 2 There are several causes of malabsorption and steatorrhea in HIV-infected patients including enteric infection, notably by giardia. Human immunodeficiency virus (HIV) infection has been associated with pancreatic exocrine dysfunction. 3,4 The pancreatic mechanism of exocrine dysfunction has not been well elucidated in the literature. Publication of CP in HIV patients is limited to isolated case reports. Patients with HIV/AIDS are predisposed to a variety of pancreatic disorders, most commonly opportunistic infections, anti-retroviral drug toxicity and neoplasms. Patients with HIV infection are also prone to common risk factors for pancreatic pathology, perhaps even more so because of other pathologies. However most pancreatic involvement in HIV infected patients is silent, and may be overshadowed by other HIV associated symptoms and signs. 5 Pancreatitis in HIV infected patients is mostly acute due to infections and antiretroviral drug toxicity. To date no study has investigated CP in HIV infected patients. Hypothesis: Given the clear specific and nonspecific risk factors for pancreatic pathology we hypothesized that chronic pancreatitis would be evident in HIV infected patients, and that the illness would be more severe in HIV infected patients. The aim of the study was to document the occurrence of CP in HIV infected patients, and to compare the profile of the patients, risk factors and the disease manifestation to HIV-infected patients. Methods Prospectively collected clinical databases of the Steve Biko Academic Hospital was reviewed for patients diagnosed with chronic pancreatitis with a minimum follow-up period of one year. Chronic pancreatitis diagnosis was based on radiological imaging demonstrating pathognomic pancreatic calcification. Patient information was collected through a research nurse-administered questionnaire on pancreatic disease. This included demographic information, smoking and alcohol use, employment history, psychosocial circumstances, exposure to commonly occurring xenobiotics and clinical information. Following appropriate counselling all patients underwent HIV testing with a HIV enzyme linked immunosorbent assay and if positive a confirmation test was performed. Newly HIV diagnosed patients were placed on ARV treatment. A history of steatorrhea (the patient described loose stools that were difficult to flush away or floated on the surface of the toilet water) or post prandial abdominal bloating relieved by the use of pancrealipase was extracted from the database. Endocrine dysfunction was diagnosed if the HbA1c was greater than or equal to 6.5% at any time. Patients were followed up at the clinic every 3 months for the development of relevant manifestations of CP. This study was approved by the University of Pretoria Research Ethics Committee (201/2017). Statistical analysis HIV infected and -uninfected patients were grouped. The groups were compared with regard to demographics, risk factors and clinical CP history. Descriptive data is represented as means and their ranges. A Student T test was performed for normally distributed continuous variables and a Mann Whitney U test was performed to assess significance of non- uniform continuous variables. A Fisher Exact test was applied to binary values. A p-value of < 0,05 was considered significant. Results Seventy six patients were identified in the databases with CP. However 12 were either lost to follow-up or diagnosed within 12 months preceding this study and hence excluded. This report analyses the remaining 64 patients with CP. Of these 22 (34%) were HIV positive Characterization of chronic calcific pancreatitis in the presence of HIV infection: Comparison with uninfected patients Correspondence M Brand email: martin.brand@up.ac.za M Brand Pretoria pancreatic diseases research group, University of Pretoria, Pretoria, South Africa GPA’s Non-PPI (Antacids, H2 blockers) PPI Habits Smoker Alcohol use Indication Headache Musculoskelet Gastrointestin Other Pattern of use General advic Take with mea Frequency Daily Twice daily Three times d Four times dai >Four times daily NSAID non-steroidal the counter; GPA’s ga pump inhibitors; H2 h Discussion The South African Ess ibuprofen as an altern first line management for ibuprofen, and co common in South Afri tertiary hospitals in th where patterns of OT UGIT bleeds have not During the study p who were admitted w 85% (n=183) of who prescription. 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