Marked elevations of serum
amylase, unexplained despite extensive evaluation in patients with
acquired immunodeficiency syndrome (
AIDS), prompted this retrospective review of 85 patients to determine the prevalence of
hyperamylasemia and identify any associated demographic and etiologic factors. Of 39 patients who had
amylase determinations, 54% had
hyperamylasemia (2/3 pancreatic, 1/3 salivary) and 31% had
pancreatitis.
Biliary tract disease, alcohol intake, and
opportunistic infections were similar in hyperamylasemic and normoamylasemic subjects. Non-Caucasian race,
intravenous drug abuse, renal dysfunction,
alkaline phosphatase elevation, and
pentamidine use were more prevalent in patients with
hyperamylasemia (p less than 0.001, p less than 0.001, p less than 0.01, p less than 0.05, and p less than 0.05, respectively). However, by stepwise deletion multiple regression analysis, only non-Caucasian race,
pentamidine use, and
Mycobacterium avium-intracellulare infection were significant, independent predictors of
hyperamylasemia (R2 = 0.65). Followed over time, in a historical prospective manner, case fatality rates (66.6% and 61.1%) and median survival times (101 and 84 days) were similar in the hyperamylasemic and normoamylasemic groups. We conclude that, although
pancreatitis occurs frequently in
AIDS,
hyperamylasemia is often of salivary origin and clinical outcome is unaffected. Certain demographic factors are strongly associated with
hyperamylasemia in
AIDS patients, but multiple, concurrent, etiologic factors are probably operative in these patients.