Ostermann Philipp Niklas, Madden Victoria J, Kemp Harriet I, Ciampi de Andrade Daniel
Translational Pain Research, Department of Anesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
African Pain Research Initiative, Department of Anaesthesia and Perioperative Medicine, Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
Pain. 2025 May 14;166(9):e160-e165. doi: 10.1097/j.pain.0000000000003596.
It is estimated that millions of people worldwide suffer from chronic pain associated with infectious diseases and their treatment. Notably, numerous pathogens can cause chronic pain in people with current or past infections but the underlying mechanisms of pain development and persistence are only partially known. To help those people, classification systems are important to differentiate chronic pain that is not affected by the infection from chronic pain that started or worsened in relation to the infection. This is especially true because these classification systems often guide treatment selection. Unfortunately, current classification systems do not reflect the complex reality of the myriad chronic pain features known to exist in the context of infectious diseases. In this article, we have therefore presented a framework to initiate discussions between the pain community, infectious disease specialists, and ICD experts to yield a proposal to add as a subgroup to the existing ICD-11 classification of chronic pain. This framework is discussed in the context of HIV-1, HTLV-1, and , three pathogens that are associated with chronic pain. We discuss diagnostic criteria, provide a definition of suitable for its inclusion into the ICD-11, but also possible limitations. We believe that a classification system that better reflects will improve clinical communication, detection of chronic pain conditions, selection of appropriate pain therapies, facilitate reimbursement by health care systems, raise awareness, and improve research, together better serving the need to treat patients.
据估计，全球数百万人患有与传染病及其治疗相关的慢性疼痛。值得注意的是，许多病原体可导致当前或既往感染患者出现慢性疼痛，但疼痛发生和持续存在的潜在机制仅部分为人所知。为帮助这些患者，分类系统对于区分不受感染影响的慢性疼痛与因感染而开始或加重的慢性疼痛非常重要。尤其如此，因为这些分类系统通常指导治疗选择。不幸的是，当前的分类系统并未反映出已知存在于传染病背景下的无数慢性疼痛特征的复杂现实。因此，在本文中，我们提出了一个框架，以启动疼痛领域、传染病专家和国际疾病分类（ICD）专家之间的讨论，从而提出一项建议，将[具体内容]作为一个亚组添加到现有的ICD - 11慢性疼痛分类中。该框架在与慢性疼痛相关的三种病原体——人类免疫缺陷病毒1型（HIV - 1）、人类嗜T淋巴细胞病毒1型（HTLV - 1）和[具体病原体]的背景下进行了讨论。我们讨论了诊断标准，提供了一个适合纳入ICD - 11的[具体内容]定义，同时也讨论了可能的局限性。我们认为，一个能更好反映[具体内容]的分类系统将改善临床沟通、慢性疼痛状况的检测、适当疼痛治疗方法的选择、促进医疗保健系统的报销、提高认识并改善研究，从而更好地满足治疗患者的需求。
