Clinical and Demographic Variables Related to Pain in HIV-Infected Individuals Treated with Effective, Combination Antiretroviral Therapy (cART)

Abstract

In this cohort treated with cART, pain was less prevalent and less likely to be associated with HIV disease progression or treatment than indicated by studies conducted prior to the widespread use of cART.

Pain Treatment and Antiretroviral Medication Adherence Among Vulnerable HIV-Positive Patients

“…Although elevated with respect to the general population, this finding is in line with prior research on HIV-positive patients, which has gauged pain prevalence to be between 40% and 80%. [1][2][3][4] Our data confirm that pain is an exceedingly common co-morbid health condition among HIV-positive individuals, including the non-elderly and those treated in an era of ARVs with lower side effect profiles. Although this study did not gather information on pain intensity or duration, prescribed pharmacotherapy to treat pain was modest, with 41.5% of those endorsing pain being untreated.…”

“…7 A small but emerging body of literature suggests that pain experience among HIV-positive patients is associated with poor ARV adherence and reduced attendance at HIV-related care visits, 2,3,14 both of which are key behavioral components of disease management to achieve viral suppression and prevent onward transmission. 15,16 Although a handful of other studies has shown no link between pain and ARV treatment adherence, 1,13 the dearth of research on this topic precludes consensus.…”

“…[1][2][3][4] The etiology of pain among HIV-positive individuals is varied, and includes infection-related inflammatory responses, secondary complications of progressive HIV disease, as well as adverse effects of treatment with antiretroviral (ARV) medications. 5 Sensory neuropathy, for example, has been estimated to affect 40-60% of treated HIV-positive individuals, 6 and often results in moderate to severe pain.…”

Characteristics of an Ambulatory Palliative Care Clinic for HIV-Infected Patients

“…2 In this chronically medically ill patient population, there is evidence that pain and nonpain symptoms are common. Estimates of pain prevalence in HIV-infected patients in the current treatment era range from 39%-55%; [3][4][5][6][7][8][9][10] however, the etiology of this pain has not been well characterized. Also, one recent study found that HIV-infected patients experience an average of eight nonpain physical and psychological symptoms, including lack of energy, numbness in the hands and feet, worrying, and feeling sad.…”

Qualitative Investigation of a Brief Chronic Pain Screening Tool in HIV-Infected Patients

“…17 Most studies of chronic pain prevalence in HIV-infected patients rely on queries pertaining to short time frames (1 day to 1 month), [5][6][7][8][9][10][11][12][13] or methods of screening for chronic pain that have not been validated in any clinical population. 13 Furthermore, well-validated pain questionnaires, such as the Brief Pain Inventory 18 and Multidimensional Pain Inventory, 19 have been used to study pain in patients with HIV, [5][6][7][8][9][10][11][12][13] but are not designed as screeners. As detailed questionnaires, they were designed to understand pain's impact on physical and emotional function in patients already known to have a pain condition, whether acute or chronic.…”