Peripheral Neuropathy in Patients With HIV: Association With Additional Pain Disorders

HIV floating in bloodstream
HIV floating in bloodstream
Patients with a diagnosis of HIV and peripheral neuropathy often have ≥1 additional pain disorders.

Patients with a diagnosis of HIV and peripheral neuropathy (HIV-PN) often have ≥1 additional pain disorders, according to an analysis published in Pain Medicine.

Investigators obtained patient data from the Clinical Data Warehouse, using International Classification of Diseases-9/10 diagnostic codes to identify patients with HIV-PN. Of 638 patients with HIV, 68 also had peripheral neuropathy (HIV-PN) and had received primary care and combination antiretroviral therapy, and the remaining patients had not been diagnosed with PN.

Patients with HIV-PN had a greater history of substance use disorder (49% vs 30%; P =.002), which the researchers suggest may be an HIV-PN risk factor. According to the findings, patients with an HIV-PN diagnosis had double the chance of being diagnosed with additional chronic pain syndromes (66% vs 32%; P <.001).

Approximately 36% of patients with HIV-PN had spinal degenerative disorders vs 12% in the population without HIV-PN (P <.001). Following adjustment for potential and clinically relevant confounders, the researchers observed that patients with HIV-PN continued to have significantly more chronic pain disorders (P <.001).

The investigators suggested that the findings may not be generalizable to the entire HIV-PN patient population, since this study examined characteristics of patients living in a low-income, urban community. Also, clinical records were the primary source of patient data, which brings into question the accuracy of HIV-PN and accompanying chronic pain diagnoses as these often depend upon the physician.

Since many patients with HIV-PN appear to have ≥1 chronic pain conditions, physicians are urged to “ask patients with HIV-PN about other types of pain and formulate the pain management plan accordingly.”

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Navis A, Jiao J, George MC, Simpson D, Robinson-Papp J. Comorbid pain syndromes in HIV-associated peripheral neuropathy. Pain Med [published online August 7, 2017]. doi:10.1093/pm/pnx129