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Part of A Practical Guide to HIV Drug Side Effects


Pancreatitis is an inflammation of the pancreas gland, the organ that secretes enzymes (which go into the gut and help you digest food) and insulin (which regulates the use of sugar). It may or may not cause symptoms such as:

  • severe nausea
  • vomiting
  • abdominal pain

If left untreated, pancreatitis can be fatal. If there is any suspicion of pancreatitis, it is crucial to get immediate medical attention.

Pancreatitis can be caused by many drugs, including the following:

  • ddI (Videx EC)
  • ddC (Hivid)
  • 3TC (alone in Epivir and in the combination drugs Combivir and Trizivir)
  • d4T (Zerit)
  • hydroxyurea (Hydrea)
  • the sulfa antibiotic Septra/Bactrim

As well, high levels of blood lipids, especially the sky-high triglycerides seen in many people on HAART, can place PHAs at increased risk for pancreatitis.

Elevations in the level of the enzyme amylase can indicate pancreatitis.

Tips for Handling Pancreatitis

The standard North American treatment for this potentially fatal problem usually consists of immediately stopping to take the problematic drug(s), along with bed rest, pain medication and fluids. However, based on evidence that the pancreas is damaged by free radicals (highly active compounds that damage cells much in the same way that rust damages a car) in the early stages of pancreatitis, researchers have successfully used antioxidants to counter this condition. In various trials, German researchers gave selenium (in doses of 500 mcg daily), combined with vitamin E (1,600 IUs) and sometimes other antioxidants (vitamin C and N-acetyl-cysteine) immediately after a pancreatitis diagnosis. Death rates plummeted and patients experienced faster recovery, less pain and shorter hospital stays. Although these studies were not in PHAs, the researchers showed that these improvements occurred regardless of the cause of the pancreatitis. So, long-term use of these nutrients might even help prevent the problem in the first place.

Last, but not least, because pancreatitis may be another condition tied to mitochondrial toxicity, therapies to treat the toxicity could be of value (see discussion of mitochondrial toxicity under "Body Distortions").

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This article was provided by Canadian AIDS Treatment Information Exchange. Visit CATIE's Web site to find out more about their activities, publications and services.
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