OBJECTIVE: We sought to study asymptomatic pancreatic enzyme abnormalities in patients with human immunodeficiency virus (HIV) infection. METHODS: Serial serum amylase determination was performed in ambulatory 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 values on at least one determination. Only 12 (14% of all patients) had a more than twofold elevation of pancreatic enzymes. Independent factors associated with abnormal pancreatic enzymes were: positive serology for chronic hepatitis B or C, history of intravenous cotrimoxazole administration for the treatment of Pneumocystis carinii pneumonia, stage B of HIV disease, and HIV risk factors other than male homosexuality (mainly intravenous drug use). None of the patients developed clinical pancreatitis. CONCLUSIONS: Asymptomatic mild to moderate elevations of amylase are common in HIV-positive patients, and are usually associated with positive serology for chronic hepatitis B or C, and medications, especially antiretrovirals and intravenous cotrimoxazole.
