Pancreatic insufficiency in patients with HIV infection: role of didanosine questioned

• DOI: 10.1111/j.1468-1293.2012.01047.x
• Publication Date: 2012-09-21T10:21:30Z
• Authors: TCS Martin; A Scourfield; N Rockwood; NK Martin; N Patel; M Nelson; BG Gazzard
• Keywords: Didanosine; Exocrine pancreatic insufficiency; Stavudine

The aim of the study was to identify possible causes pancreatic insufficiency in patients with HIV infection.A retrospective analysis 233 HIV-positive for whom faecal elastase measurement available performed investigate potential associations core demographic data, infection characteristics, degree immunosuppresion, exposure antiretroviral therapy (ART), alcohol misuse, diabetes, hepatitis C virus (HCV) infection, triglyceride and cholesterol levels symptomatology. response enzyme replacement evidence also evaluated.Of patients, 104 (45%) had exocrine (faecal < 200 mcg/g). A positive association found HCV (P = 0.007), previous or current treatment 0.003), misuse history 0.006) presence steatorrhoea 0.03). There no demonstrated between didanosine (ddI) 0.43) stavudine (d4T) 0.62). Seventy-seven per cent who were treated enzymatic supplementation reported a subjective improvement symptoms.Faecal sampling should form part routine work-up chronic diarrhoea even absence 'traditional' risk factors such as ddI exposure. In particular, if patient has steatorrhoea, their serology is positive, they be considered investigation. Treatment appears effective caused by majority patients.