Burden of HIV-Related Neuropathic Pain in the United States

Mann, Rachael; Sadosky, Alesia; Schaefer, Caroline; Baik, Rebecca; Parsons, Bruce; Nieshoff, Edward; Stacey, Brett R.; Tuchman, Michael; Nalamachu, Srinivas

doi:10.1177/2325957415592474

Cited by 18 publications

(12 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These studies did not generally make comparisons to a similar HIV-negative control group, and therefore it is unclear whether pain-related resource use in PLWH is any higher than would be expected in a similarly aged group in the general population. In one study of veterans with and without HIV in the United States [43], 13% of participants reported nonmedical use of prescription opioids, although in adjusted analyses no association was reported with HIV status.…”

Section: Discussionmentioning

confidence: 99%

Pain in people living with HIV and its association with healthcare resource use, well being and functional status

Sabin¹,

Harding

Bagkeris³

et al. 2018

Aids

View full text Add to dashboard Cite

Objective: We describe the prevalence of pain and its associations with healthcare resource utilisation and quality-of-life. Design: The POPPY Study recruited three cohorts: older PLWH (≥50 years, n=699), younger demographically/lifestyle similar PLWH (<50 years, n=374) and older demographically/lifestyle similar HIV-negative (≥50 years, n=304) people from April 2013-February 2016. Methods: Current pain and pain-related healthcare use was collected via a self-reported questionnaire. Logistic regression assessed between-group differences in the prevalence of pain in the past month and current pain after controlling for potential confounders. Associations between current pain and healthcare resource use, reported joint problems, depressive symptoms, quality-of-life and functional status were assessed in PLWH using Mann-Whitney U and Chi-squared tests. Results: Pain in the past month was reported by 473/676 (70.0%) older PLWH, 224/357 (62.7%) younger PLWH and 188/295 (63.7%) older HIV-negative controls (p=0.03), with current pain reported in 330 (48.8%), 134 (37.5%) and 116 (39.3%), respectively (p=0.0007). Older PLWH were more likely to experience current pain, even after adjustment for confounders. Of those with pain in the past month, 56/412 (13.6%) had missed days of work or study due to pain, and 520 (59%) had seen a doctor about their pain. PLWH experiencing current pain had more depressive symptoms, poorer quality-of-life on all domains, and greater functional impairment, regardless of age group. Conclusions: Even in the effective ART era, pain remains common in PLWH and has a major impact on quality-of-life and associated healthcare and societal costs. Interventions are required to assist clinicians and PLWH to proactively manage pain.

show abstract

Section: Discussionmentioning

confidence: 99%

Pain in people living with HIV and its association with healthcare resource use, well being and functional status

Sabin¹,

Harding

Bagkeris³

et al. 2018

Aids

View full text Add to dashboard Cite

show abstract

“…This finding is consistent with previous work. A different set of studies was conducted to determine the clinical presentation and burden of illness in six different NeP conditions: HIV NeP, 51 posttrauma/postsurgical NeP, 52 spinal cord injury with NeP, 53 CLBP, 42 painful diabetic neuropathy, 54 and painful peripheral neuropathy with small-fiber involvement. 42 In these studies, physicians and patients were required to answer questions regarding NeP, comorbid medical and psychiatric conditions, and medication to treat NeP.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it is not surprising that patients with NeP report an increased incidence of other painful conditions, regardless of their origin. 42 , 51 – 55 It is also possible that the 80% specificity 22 of PainDetect coded some nociceptive patients as false-positive NeP patients. If our findings are corroborated in future studies, this has important implications for general pain management and treatment.…”

Section: Discussionmentioning

confidence: 99%

The prevalence of probable neuropathic pain in the US: results from a multimodal general-population health survey

DiBonaventura¹,

Sadosky²,

Concialdi³

et al. 2017

JPR

Self Cite

108

View full text Add to dashboard Cite

BackgroundThe prevalence of neuropathic pain (NeP) has been estimated within specific health conditions; however, there are no published data on its broad prevalence in the US. The current exploratory study addresses this gap using the validated PainDetect questionnaire as a screener for probable NeP in a general-population health survey conducted with a multimodal recruitment strategy to maximize demographic representativeness.Materials and methodsAdult respondents were recruited from a combination of Internet panels, telephone lists, address lists, mall-based interviews, and store-receipt invitations using a random stratified-sampling framework, with strata defined by age, sex, and race/ethnicity. Older persons and minorities were oversampled to improve prevalence estimates. Results were weighted to match the total adult US population using US Census data. Demographic information was collected, and respondents who experienced physical pain in the past 12 months completed the PainDetect and provided additional pain history. A cutoff score of 19 or greater on the PainDetect was used to define probable NeP.ResultsA total of 24,925 respondents (average response rate 2.5%) provided demographic data (52.2% female, mean age 51.5 years); 15,751 respondents reported pain (63.7%), of which 2,548 (15.7%, 95% confidence interval 14.9%–16.5%) had probable NeP based on the PainDetect, which was 10% (95% confidence interval 9.5%–10.5%) of all respondents. Among those reporting pain, the prevalence of probable NeP among Blacks and Hispanics was consistently higher than Whites in each age- and sex group. The highest prevalence among those with pain was among male Hispanics 35–44 years (32.4%) and 45–54 years (24.2%) old. The most commonly used medications reported by those with probable NeP were nonsteroidal anti-inflammatory drugs (44.2%), followed by weak opioids (31.7%), antiepileptics (10.9%), and strong opioids (10.9%).ConclusionThis is the first study to provide an estimate of the prevalence of probable NeP in the US, showing significant variation by age and ethnicity.

show abstract

“…Patients with HIV-SN typically present with numbness, parestethias, and pain most severely affecting the distal extremities (5)(6)(7). Although HIV-SN is not a lifethreatening condition, the painful symptoms are often poorly responsive to existing analgesic medications and can negatively impact patients' quality of life (8)(9)(10)(11)(12). Lack of effective treatment stems from our incomplete understanding of the mechanisms underlying sensory nerve injury in the context of HIV infection.…”

Section: Introductionmentioning

confidence: 99%

SIV-Induced Immune Activation and Metabolic Alterations in the Dorsal Root Ganglia During Acute Infection

Mangus¹,

Weinberg²,

Knight³

et al. 2018

Journal of Neuropathology &Amp; Experimental Neurology

View full text Add to dashboard Cite

Human immunodeficiency virus-associated sensory neuropathy (HIV-SN) remains a frequent neurologic complication of HIV infection. Little is known about alterations in the peripheral nervous system during the early stages of HIV, a time when neuroprotective interventions may be most beneficial. We performed Nanostring gene expression analysis on lumbar dorsal root ganglia (DRG) from 6 simian immunodeficiency virus (SIV)-infected pigtailed macaques killed at 7 days post-inoculation and 8 uninfected controls. We found significant upregulation of many genes involved in immune signaling and activation in the DRG. Among genes related to glutamate metabolism, there was significant upregulation of glutamine synthetase (GS), while glutaminase (GLS) was downregulated. Several genes involved in the oxidative stress response also showed significant differential regulation in the DRG of 7d SIV-infected animals, with superoxide dismutase-2 (SOD2) showing the greatest median fold change compared to controls. Novel findings in the DRG were compared to corresponding brain data and further investigated at the protein level by Western blotting and immunohistochemistry. Together with our previous finding of significant epidermal nerve fiber loss at 14 days post-SIV infection, results of this study demonstrate that immune activation and altered cellular metabolism at in the DRG precede and likely contribute to early sensory nerve injury in HIV-SN.

show abstract

Burden of HIV-Related Neuropathic Pain in the United States

Abstract: The impact of HIV-NeP on health status, physical function, and depression increases with severity, resulting in substantial clinical and economic burden.

Cited by 18 publications

References 28 publications

Pain in people living with HIV and its association with healthcare resource use, well being and functional status

Pain in people living with HIV and its association with healthcare resource use, well being and functional status

The prevalence of probable neuropathic pain in the US: results from a multimodal general-population health survey

SIV-Induced Immune Activation and Metabolic Alterations in the Dorsal Root Ganglia During Acute Infection

Contact Info

Product

Resources

About