Hirschfeld S, Moss H, Dragisic K, Smith W, Pizzo P A
Pediatric Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20904, USA.
Pediatrics. 1996 Sep;98(3 Pt 1):449-52.
Children with human immunodeficiency virus (HIV) infection have multiple complications associated with the disease process. Many of these complications are potentially painful and could affect the patient's quality of life. We examined the incidence and characteristics of the perception of pain in a cohort of families with children with HIV infection.
A questionnaire was developed and validated with a cohort of families with children with cancer. In a survey of families at the Pediatric Branch of the National Cancer Institute, 61 children with HIV infection and their care givers, along with 19 children with cancer and their care givers, were interviewed to determine the incidence and impact of pain.
Fifty-nine percent of the HIV-infected children and 55% of their care givers described pain as a component of their illness that impacted on their lives. Younger children and girls tended to report more pain. There was also a tendency for biological parents to expect and to treat more pain than foster parents, although there was no difference in the incidence of pain that biological and foster parents reported for their children. No differences were found between parents who were HIV positive and those who were not. In addition, no correlations were noted in incidence, expectation, or impact of pain with disease progression or surrogate markers such as CD4 counts. Pain in HIV-infected patients tended to be either in the gastrointestinal tract or limbs and usually responded to nonsteroidal anti-inflammatory therapy. The patients with cancer reported an incidence (47%) and impact of pain similar to those of previously reported studies on pediatric patients with cancer.
Pain is common among children infected with HIV and can adversely impact on their lives, and its management should be a component of the general care of these patients.
感染人类免疫缺陷病毒（HIV）的儿童会出现多种与疾病进程相关的并发症。其中许多并发症可能会引起疼痛，并可能影响患者的生活质量。我们调查了一组感染HIV儿童家庭中疼痛感知的发生率及特征。
设计了一份问卷，并在一组患癌儿童家庭中进行了验证。在美国国立癌症研究所儿科分院对家庭进行的一项调查中，对61名感染HIV的儿童及其照料者，以及19名患癌儿童及其照料者进行了访谈，以确定疼痛的发生率及其影响。
59%的感染HIV儿童及其55%的照料者将疼痛描述为影响其生活的疾病组成部分。年幼的儿童和女孩往往报告更多疼痛。亲生父母比养父母更倾向于预期并治疗更多疼痛，尽管亲生父母和养父母报告的孩子疼痛发生率没有差异。HIV阳性和阴性的父母之间未发现差异。此外，在疼痛的发生率、预期或影响与疾病进展或替代指标（如CD4细胞计数）之间未发现相关性。感染HIV的患者疼痛往往出现在胃肠道或四肢，通常对非甾体抗炎治疗有反应。患癌患者报告的疼痛发生率（47%）及其影响与先前关于患癌儿科患者的研究报告相似。
疼痛在感染HIV的儿童中很常见，会对他们的生活产生不利影响，其管理应成为这些患者常规护理的一部分。
