Etiology and severity features of acute pancreatitis in HIV-positive patients with different immune status.

IF 0.5 Q4 SURGERY Turkish Journal of Surgery Pub Date : 2023-03-01 DOI:10.47717/turkjsurg.2023.5939
Dmitriy Plotkin, Umedzhon Gafarov, Mikhail Reshetnikov, Sergey Sterlikov, Elena Bogorodskaya
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Abstract

Objectives: Acute pancreatitis is common in HIV-infected patients; however, the causes and severity of pancreatitis in HIV-positive patients have a number of significant features that affect both the severity of destruction of the pancreas and the methods of diagnosis and treatment.

Material and methods: Anamnestic data, results of diagnosis and treatment of two groups of patients with acute pancreatitis were analyzed. The first group included 79 patients with acute pancreatitis combined with HIV infection who were admitted to the clinic for the period from 2017 to 2021. In people living with HIV, drugs and infectious agents caused acute pancreatitis in 11.4% and 24.1% of the cases, respectively. As our study showed, in patients with normal immune status, the drug etiology of pancreatitis prevailed in the structure of the causes of AP, in patients with immunodeficiency, infectious causes of pancreatitis were dominant.

Results: According to the results of data analysis, it is clear that HIV infection is a factor that makes the course of pancreatitis about two times worse regardless of the presence of immunosuppression. The etiological structure of HIV-associated acute pancreatitis directly depends on the patient's immune status and differs in many ways from that of HIV-negative patients or patients receiving ART.

Conclusion: The severity of the disease and the risk of death remain high in acute pancreatitis caused by infectious agents against the background of immunosuppression.

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不同免疫状态hiv阳性患者急性胰腺炎的病因及严重程度特征
目的:急性胰腺炎在hiv感染者中很常见;然而,hiv阳性患者胰腺炎的病因和严重程度有许多显著的特征,这些特征既影响胰腺破坏的严重程度,也影响诊断和治疗的方法。材料与方法:对两组急性胰腺炎患者的记忆资料、诊治结果进行分析。第一组包括79名急性胰腺炎合并艾滋病毒感染的患者,他们在2017年至2021年期间入院。在艾滋病毒感染者中,药物和传染性病原体分别在11.4%和24.1%的病例中引起急性胰腺炎。我们的研究表明,在免疫状态正常的患者中,药物性胰腺炎病因在AP病因结构中占主导地位,在免疫缺陷患者中,感染性胰腺炎病因占主导地位。结果:根据数据分析的结果,很明显,无论是否存在免疫抑制,HIV感染都是使胰腺炎病程加重约两倍的因素。hiv相关性急性胰腺炎的病因结构直接取决于患者的免疫状态,在许多方面与hiv阴性患者或接受抗逆转录病毒治疗的患者不同。结论:在免疫抑制的背景下,感染性病原体引起的急性胰腺炎的病情严重程度和死亡风险仍然很高。
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16
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