Comorbid Pain Syndromes in HIV-Associated Peripheral Neuropathy

Pain Med. 2018 Jul 1;19(7):1445-1450. doi: 10.1093/pm/pnx129.

Abstract

Objective: Peripheral neuropathy (PN) is a common complication of HIV. There is increasing awareness that some forms of PN, particularly small-fiber neuropathies, can be associated with chronic widespread pain syndromes. Given the high prevalence of both PN and chronic pain in HIV, we sought to determine whether patients with a diagnosis of HIV-PN were more likely to experience other chronic pain syndromes.

Methods: Data were obtained from the Clinical Data Warehouse maintained by our institution. All HIV-infected patients receiving standard of care antiretroviral therapy in our institution's primary care HIV clinic (N = 638) were included. Diagnoses of HIV-PN and other chronic pain disorders were established based on clinician-assigned ICD-9/10 codes.

Results: Sixty-eight patients (11%) had a diagnosis of HIV-PN. Patients with HIV-PN were more than twice as likely to have other chronic pain disorders (66% vs 32%, χ2 = 30.3, P < 0.001). Patients with HIV-PN were also older and more likely to have substance use and psychiatric disorders; however, the association of HIV-PN with other chronic pain disorders persisted after adjusting for relevant confounders (χ2(5) = 81.38, P < 0.001).

Conclusions: Patients with HIV-PN commonly experience other chronic pain disorders. Clinicians managing HIV-PN should seek a broad understanding of patients' pain experience as this may alter management strategies. Researchers studying HIV-PN should consider how the presence of other pain disorders might affect outcomes.

MeSH terms

  • Adult
  • Comorbidity
  • Female
  • HIV Infections / diagnosis*
  • HIV Infections / epidemiology*
  • Humans
  • Male
  • Middle Aged
  • Pain / diagnosis*
  • Pain / epidemiology*
  • Peripheral Nervous System Diseases / diagnosis*
  • Peripheral Nervous System Diseases / epidemiology*
  • Syndrome