Continued High Prevalence and Adverse Clinical Impact of Human Immunodeficiency Virus–Associated Sensory Neuropathy in the Era of Combination Antiretroviral Therapy

Macrophage-Mediated Dorsal Root Ganglion Damage Precedes Altered Nerve Conduction in SIV-Infected Macaques

“…1,2 The most typical clinical manifestation of HIV-induced peripheral nervous system disease is a debilitating syndrome called distal sensory polyneuropathy (DSP) with gradual onset of bilateral pain described as aching, painful numbness or burning that is most severe in the soles of the feet. 3,4 Although not life threatening, HIVinduced peripheral neuropathy markedly affects the quality of life of many HIV-infected patients.…”

Role of TNF block genetic variants in HIV-associated sensory neuropathy in black Southern Africans

“…1,2 This debilitating and often painful condition is predicted to remain a significant long-term complication of HIV infection in Africa, irrespective of changes to treatment guidelines. [3][4][5] Two recent studies in South Africa reported that about 60% of HIV-positive out-patients on ART had HIV-SN, and over two-thirds of these patients had a painful neuropathy. 6,7 While not fatal, HIV-SN has a significant negative impact on psychological, social and economic well-being 4 and there are no proven treatments for the pain.…”

“…[3][4][5] Two recent studies in South Africa reported that about 60% of HIV-positive out-patients on ART had HIV-SN, and over two-thirds of these patients had a painful neuropathy. 6,7 While not fatal, HIV-SN has a significant negative impact on psychological, social and economic well-being 4 and there are no proven treatments for the pain. 8 The pathogenesis of HIV-SN has not been fully explained, but human [9][10][11] and animal studies 12 indicate that inflammation plays a central role.…”

Pharmacological treatment of painful HIV-associated sensory neuropathy

“…[1][2][3] Painful HIV-SN is associated with substantially reduced health-related quality of life, [2] but evidence-based analgesic options are lacking. [4] Several national and international agencies [5][6][7][8][9][10] have recommended the tricyclic antidepressant amitriptyline for HIV-SN pain, despite evidence that this is no better than placebo.…”

“…[4] Several national and international agencies [5][6][7][8][9][10] have recommended the tricyclic antidepressant amitriptyline for HIV-SN pain, despite evidence that this is no better than placebo. [11,13] Despite the high prevalence [1,2] and considerable impact of HIV-SN, and the lack of proven effective analgesics, few data exist describing the frequency, type and dosage of pain medication patients are receiving. We are aware of only one retrospective case review, with low-quality case ascertainment criteria, that attempted to describe the treatment of HIV-SN pain in a clinical setting.…”