I am a white 42 yrs. male. I have been a lacto-ovarian vegetarian (I have an occasional egg or slice of cheese, however I prefer soy milk to dairy) for almost 3 years. I have been a complete nonsmoker for almost two years, however, prior to that I did smoke cigarettes, and I have been alcohol-free for almost two years (however, prior to that, I did have an occasional glass of wine or beer).
I have been HIV+ for almost 18 yrs and asymptomatic. I have an undetectable viral load and a CD4 count around 276. I have also been diagnosed over the years with a peptic ulcer (although I believe that this no longer is an issue), hyperlipidemia, nonalcoholic fatty liver disease bordering on nonalcoholic steatohepatitis (confirmed by a liver biopsy), lipoatrophy, osteopenia, and pancreatitis (I have sustained half a dozen attacks, one in particular where I was hospitalized for a month in Mass General).
It is believed that all of these conditions have been medication-induced. My concern, however, is the frequency of my pancreatitis. I sustained an attack in November last year and most recently another in March of this year. I have had ultrasounds, and most recently an MRI CP as well as a fecal elastase done and no significant abnormality was found. Recent blood work has indicated that my triglycerides are 377 (nothing compared to what I’ve had in the past, however, my last bout in March occurred when I had only 600 and something), my lipase is 456 and amylase is 101. As an aside, my glucose has been fluctuating around 125 for a while and my liver functions are AST 165 and ALT 226.
Despite being told that my current medications do not aggravate the pancreas, I have my doubts (since my HIV medications have always been the culprit of my physical demise).
Isentress (raltegravir) 400 mg tablet BID
Emtriva (emtricitabine) 200 mg capsules QHS
Sustiva (efavirenz) 600 mg tablet QHS
Tricor (fenofibrate) 48 mg tablet QHS
Xyzal (levocetirizine dihyrochloride) 5 mg tablet QHS
Boniva (abandonee sodium) 150 mg tablet once a month
Loperamide Hydrochloride tablets PRN
Rozerem (ramelteon) 8 mg tablet PRN
Butal-APAP-325 CAFF TAB MIK (substituted for Fioricet) PRN
Zovirax (acyclovir cream) 5 mg PRN
It has been suggested that perhaps these bouts of pancreatitis are simply idiopathic, or that I have some sort of autoimmune pancreatitis. I was also informed that I could have an endoscopic pancreatic function test done in order to further pursue this problem.
What, if anything, should I do?
Thank you for taking the time to review and respond to my question.