A large proportion of HIV-positive patients experience frequent headaches that often impact their quality of life, according to findings from a cross-sectional study published in Headache.

For this study, investigators sought to determine headache frequency and impact of headache on life quality in 119 patients (63% men; mean age, 35.5 years) with HIV and CD4+ T lymphocyte counts >500. To obtain results, a semistructured interview, the Headache Impact Test (HIT-6), and the Hospital Anxiety and Depression Scale were administered to all subjects.

The majority of patients in this cohort (87%) reported having frequent headaches, 45% had migraines, 42% had tension-type headaches, and 45% reported having substantial and severe impact headaches.

A total of 11 patients reported experiencing headaches after their HIV diagnosis and experienced greater migraine frequency compared with the other study participants (72% vs 43%, respectively; P <.05), higher headache intensity (6±2 vs 8±2; P <.01), and greater impact on life (evaluated with HIT-6: 60±11 vs 51±12; P =.02). Spearman analysis indicated no association between the number of CD4+ T lymphocytes and headache intensity (correlation coefficient, r=0.117; P =.238), headache frequency (r=0.131; P =.155), or impact headache (r=0.085; P =.356).

According to the investigators, this patient cohort did not represent the entire HIV-positive population, as subjects in this study were not taking antiretroviral medications, did not present with severe immunosuppression, and were recently diagnosed.

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The investigators suggest that numerous mechanisms may play a role in the greater frequency of headaches in HIV-positive patients, including the “release of inflammatory cytokines, alteration of the metabolism of cerebral serotonin during viral infection, and increased levels of cerebral glutamate.”

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Reference

Sampaio Rocha-Filho PA, Torres RCS, Ramos Montarroyos U. HIV and headache: A cross-sectional study [published online September 14, 2017]. Headache. doi: 10.1111/head.13183