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HIV 相关周围神经病变中的共病性疼痛综合征。

Comorbid Pain Syndromes in HIV-Associated Peripheral Neuropathy.

机构信息

Department of Neurology, Icahn School of Medicine at Mount Sinai Beth Israel, New York, New York.

Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

出版信息

Pain Med. 2018 Jul 1;19(7):1445-1450. doi: 10.1093/pm/pnx129.

DOI:10.1093/pm/pnx129
PMID:29024980
Abstract

OBJECTIVE

Peripheral neuropathy (PN) is a common complication of HIV. There is increasing awareness that some forms of PN, particularly small-fiber neuropathies, can be associated with chronic widespread pain syndromes. Given the high prevalence of both PN and chronic pain in HIV, we sought to determine whether patients with a diagnosis of HIV-PN were more likely to experience other chronic pain syndromes.

METHODS

Data were obtained from the Clinical Data Warehouse maintained by our institution. All HIV-infected patients receiving standard of care antiretroviral therapy in our institution's primary care HIV clinic (N = 638) were included. Diagnoses of HIV-PN and other chronic pain disorders were established based on clinician-assigned ICD-9/10 codes.

RESULTS

Sixty-eight patients (11%) had a diagnosis of HIV-PN. Patients with HIV-PN were more than twice as likely to have other chronic pain disorders (66% vs 32%, χ2 = 30.3, P < 0.001). Patients with HIV-PN were also older and more likely to have substance use and psychiatric disorders; however, the association of HIV-PN with other chronic pain disorders persisted after adjusting for relevant confounders (χ2(5) = 81.38, P < 0.001).

CONCLUSIONS

Patients with HIV-PN commonly experience other chronic pain disorders. Clinicians managing HIV-PN should seek a broad understanding of patients' pain experience as this may alter management strategies. Researchers studying HIV-PN should consider how the presence of other pain disorders might affect outcomes.

摘要

目的

周围神经病变(PN)是 HIV 的常见并发症。人们越来越意识到,某些形式的 PN,特别是小纤维神经病变,可能与慢性广泛性疼痛综合征有关。鉴于 HIV 患者中 PN 和慢性疼痛的高患病率,我们试图确定诊断为 HIV-PN 的患者是否更有可能经历其他慢性疼痛综合征。

方法

数据来自我们机构维护的临床数据仓库。我们机构的初级保健 HIV 诊所中接受标准护理抗逆转录病毒治疗的所有 HIV 感染患者(N=638)均包括在内。根据临床医生分配的 ICD-9/10 代码确定 HIV-PN 和其他慢性疼痛障碍的诊断。

结果

68 名患者(11%)诊断为 HIV-PN。患有 HIV-PN 的患者发生其他慢性疼痛障碍的可能性是其两倍多(66%比 32%,χ2=30.3,P<0.001)。患有 HIV-PN 的患者年龄也更大,更有可能存在物质使用和精神障碍;然而,在调整相关混杂因素后,HIV-PN 与其他慢性疼痛障碍之间的关联仍然存在(χ2(5)=81.38,P<0.001)。

结论

患有 HIV-PN 的患者常经历其他慢性疼痛障碍。管理 HIV-PN 的临床医生应广泛了解患者的疼痛体验,因为这可能会改变管理策略。研究 HIV-PN 的研究人员应考虑其他疼痛障碍的存在可能如何影响结果。

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