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Patient with Human Immunodeficiency Virus (HIV)

  • James RomanoEmail author
  • Harsh Sachdeva
Chapter
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Abstract

Pain is one of the most commonly reported symptoms among patients with Human Immunodeficiency Virus (HIV)/Acquired Immunodeficiency Syndrome (AIDS). The location of many pain symptoms are beginning to fall parallel to the aging general population such as osteoarthritis, degenerative disk disease and spinal stenosis—with this in mind we will emphasize neuropathic pain as it relates to the HIV viral and treatment exposure. The following chapter will start with a discussion on epidemiology and the history of disease. We will create a foundation of understanding by discussing known and proposed pathophysiology for pain symptoms. Diagnosis and management will proceed in a stepwise and organized fashion, addressing established and novel approaches to treatment. At the end of the chapter, we will explore some of the management considerations as well as obstacles specific to HIV related pain in the hospitalized patient.

Keywords

Neuropathy Neuropathic pain Human immunodeficiency virus Highly active antiretroviral therapy Pain management Multimodal analgesia Anticonvulsants 

References

  1. 1.
    Basic Statistics | HIV Basics | HIV/AIDS | CDC. Centers for Disease Control and Prevention. https://www.cdc.gov/hiv/basics/statistics.html.
  2. 2.
    Gallo RC, Montagnier L. The discovery of HIV as the cause of AIDS. N Engl J Med. 2003;349(24):2283–5.PubMedGoogle Scholar
  3. 3.
    Parker RR, Stein DJ, Jelsma J. Pain in people living with HIV/AIDS: a systemic review. J Int AIDS Soc. 2014;17:18719.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Jiao JM, So E, Jebakumar J, George MC, Simpson DM, Robinson-Papp J. Chronic pain disorders in HIV primary care: clinical characteristics and association with healthcare utilization. Pain. 2016;157(4):931–7.PubMedGoogle Scholar
  5. 5.
    Verma A. Epidemiology and clinical features of HIV-1 associated neuropathies. J Peripher Nerv Syst. 2001;6(1):8–13.PubMedGoogle Scholar
  6. 6.
    Stavros K, Simpson DM. Understanding the etiology and management of HIV-associated peripheral neuropathy. Curr HIV/AIDS Rep. 2014;11(3):195–201.PubMedGoogle Scholar
  7. 7.
    Robinson-Papp J, Gonzalez-Duarte A, Simpson D, Rivera-Mindt M, Morgello S. The roles of ethnicity and antiretrovirals in HIV-associated polyneuropathy: a pilot study. J Acquir Immune Defic Syndr. 2009;51(5):569–73.PubMedPubMedCentralGoogle Scholar
  8. 8.
    Benzon HT, Raja S, Liu SS, Fishman S, Cohen SP. Essentials of pain medicine. Philadelphia: Elsevier; 2018.Google Scholar
  9. 9.
    Pardo CA, et al. HIV neuropathy: insights in the pathology of HIV peripheral nerve disease. J Peripher Nerv Syst. 2001;6(1):21–7.PubMedGoogle Scholar
  10. 10.
    Wulff E, Wang A, Simpson D. HIV-associated peripheral neuropathy. Drugs. 2000;59(6):1251–60.PubMedGoogle Scholar
  11. 11.
    Robinson-Papp J, Simpson DM. Neuromuscular diseases associated with HIV-1 infection. Muscle Nerve. 2009;40:1043–53.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Keltner JR, Fennema-Notestine C, Vaida F, et al. HIV-associated distal neuropathic pain is associated with smaller total cerebral cortical gray matter. J Neurovirol. 2014;20(3):209–18.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Chen H, Clifford DB, Deng L, et al. Peripheral neuropathy in ART-experienced patients: prevalence and risk factors. J Neurovirol. 2013;19(6):557–64.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Baron R, Binder A, Wasner G. Neuropathic pain: diagnosis, pathophysiological mechanisms, and treatment. Lancet Neurol. 2010;9(8):807–19.PubMedPubMedCentralGoogle Scholar
  15. 15.
    Richardson JL, Heikes B, Karim R, Weber K, Anastos K, Young M. Experience of pain among women with advanced HIV disease. AIDS Patient Care STDs. 2009;23(7):503–11.  https://doi.org/10.1089/apc.2008.0128.CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Ferrari LF, Levine JD. Alcohol consumption enhances antiretroviral painful peripheral neuropathy by mitochondrial mechanisms. Eur J Neurosci. 2010;32(5):811–8.PubMedPubMedCentralGoogle Scholar
  17. 17.
    Conigliaro J, et al. How harmful is hazardous alcohol use and abuse in HIV infection: do health care providers know who is at risk? JAIDS J Acquir Immune Defic Syndr. 2003;33(4):521–5.PubMedGoogle Scholar
  18. 18.
    Trafton JA, Sorrell JT, Holodniy M, et al. Outcomes associated with a cognitive-behavioral chronic pain management program implemented in three public HIV primary care clinics. J Behav Health Serv Res. 2011;39(2):158–73.  https://doi.org/10.1007/s11414-011-9254-y.CrossRefGoogle Scholar
  19. 19.
    Dorfman D, George MC, Schnur J, Simpson DM, Davidson G, Montgomery G. Hypnosis for treatment of HIV neuropathic pain: a preliminary report. Pain Med. 2013;14(7):1048–56.PubMedGoogle Scholar
  20. 20.
    Hahn K, Arendt G, Braun JS, et al. A placebo-controlled trial of gabapentin for painful HIV-associated sensory neuropathies. J Neurol. 2004;251(10):1260–6.PubMedGoogle Scholar
  21. 21.
    Simpson DM, Mcarthur JC, Olney R, et al. Lamotrigine for HIV-associated painful sensory neuropathies: a placebo-controlled trial. Neurology. 2003;60(9):1508–14.PubMedGoogle Scholar
  22. 22.
    Merlin JS, Bulls HW, Vucovich LA, Edelman EJ, Starrels JL. Pharmacologic and non-pharmacologic treatments for chronic pain in individuals with HIV: a systematic review. AIDS Care. 2016;28(12):1506–15.PubMedPubMedCentralGoogle Scholar
  23. 23.
    Becker WC, Gordon K, Edelman EJ, et al. Trends in any and high-dose opioid analgesic receipt among aging patients with and without HIV. AIDS Behav. 2016;20(3):679–86.PubMedPubMedCentralGoogle Scholar
  24. 24.
    Liu B, Liu X, Tang SJ. Interactions of opioids and HIV infection in the pathogenesis of chronic pain. Front Microbiol. 2016;7:103.  https://doi.org/10.3389/fmicb.2016.00103. Published 2016 Feb 10.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Shi Y, Shu J, Liang Z, Yuan S, Tang S-J. Oligodendrocytes in HIV-associated pain pathogenesis. Mol Pain. 2016;12:1–7.Google Scholar
  26. 26.
    Weisberg DF, Gordon KS, Barry DT, et al. Long-term prescription of opioids and/or benzodiazepines and mortality among HIV-infected and uninfected patients. J Acquir Immune Defic Syndr. 2015;69(2):223–33.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Clifford DB, Simpson DM, Brown S, et al. A randomized, double-blind, controlled study of NGX-4010, a capsaicin 8% dermal patch, for the treatment of painful HIV-associated distal sensory polyneuropathy. JAIDS J Acquir Immune Defic Syndr. 2012;59(2):126–33.PubMedGoogle Scholar
  28. 28.
    Cortright DN, Szallasi A. Biochemical pharmacology of the vanilloid receptor TRPV1. An update. Eur J Biochem. 2004;271(10):1814–9.PubMedGoogle Scholar
  29. 29.
    Estanislao L, Carter K, Mcarthur J, Olney R, Simpson D. A randomized controlled trial of 5% lidocaine gel for HIV-associated distal symmetric polyneuropathy. JAIDS J Acquir Immune Defic Syndr. 2004;37(5):1584–6.PubMedGoogle Scholar
  30. 30.
    McArthur J, Yiannoutsos C, Simpson D, Adornato B, Singer E, Hollander H, Marra C, Rubin M, Cohen B, Tucker T, Navia B, Schifitto G, Katzenstein D, Rask C, Zaborski L, Smith M, Shriver S, Millar L, Clifford D. A phase II trial of nerve growth factor for sensory neuropathy associated with HIV infection. Neurology. 2000;54(5):1080–8.PubMedGoogle Scholar
  31. 31.
    Phillips TJC, Cherry CL, Cox S, Marshall SJ, Rice ASC. Pharmacological treatment of painful HIV-associated sensory neuropathy: a systematic review and meta-analysis of randomised controlled trials. PLoS One. 2010;5(12):e14433.PubMedPubMedCentralGoogle Scholar
  32. 32.
    Youle M, Osio M, ALCAR Study Group. A double-blind, parallel group, placebo-controlled, multicentre study of acetyl L-carnitine in the symptomatic treatment of antiretroviral toxic neuropathy in patients with HIV-1 infection. HIV Med. 2007;8(4):241–50.PubMedGoogle Scholar
  33. 33.
    Abrams DI, Jay CA, Shade SB, et al. Cannabis in painful HIV-associated sensory neuropathy: a randomized placebo-controlled trial. Neurology. 2007;68(7):515–21.PubMedGoogle Scholar
  34. 34.
    Ebbert JO, Scharf EL, Hurt RT. Medical cannabis. Mayo Clin Proc. 2018;93(12):1842–7.PubMedGoogle Scholar
  35. 35.
    Campbell CM, Jamison RN, Edwards RR. Psychological screening/phenotyping as predictors for spinal cord stimulation. Curr Pain Headache Rep. 2012;17(1):307.Google Scholar
  36. 36.
    Knezevic NN, Candido KD, Rana S, Knezevic I. The use of spinal cord neuromodulation in the management of HIV-related polyneuropathy. Pain Physician. 2015;18(4):643–50.Google Scholar
  37. 37.
    Breivika H. Fifty years on the Visual Analogue Scale (VAS) for pain-intensity is still good for acute pain. But multidimensional assessment is needed for chronic pain. Scand J Pain. 2016;11(1):150–2.Google Scholar
  38. 38.
    Lin RJ, Reid MC, Liu LL, Chused AE, Evans AT. The barriers to high-quality inpatient pain management. Am J Hosp Palliat Care. 2014;32(6):594–9.PubMedPubMedCentralGoogle Scholar
  39. 39.
    Larue F, Fontaine A, Colleau SM. Underestimation and undertreatment of pain in HIV disease: multicentre study. BMJ. 1997;314(7073):23–8.PubMedPubMedCentralGoogle Scholar
  40. 40.
    Jiao JM, So E, Jebakumar J, George MC, Simpson DM, Robinson-Papp J. Chronic pain disorders in HIV primary care. Pain. 2016;157(4):931–7.PubMedGoogle Scholar
  41. 41.
    Ford N, Shubber Z, Meintjes G, et al. Causes of hospital admission among people living with HIV worldwide: a systematic review and meta-analysis. Lancet HIV. 2015;2(10):e438–44.PubMedGoogle Scholar
  42. 42.
    Bruce RD, Merlin J, Lum PJ, et al. 2017 HIVMA of IDSA clinical practice guideline for the management of chronic pain in patients living with HIV. Clin Infect Dis. 2017;65(10):e1–e37.PubMedPubMedCentralGoogle Scholar
  43. 43.
    Arumugam S, Lau CSM, Chamberlain RS. Use of preoperative gabapentin significantly reduces postoperative opioid consumption: a meta-analysis. J Pain Res. 2016;9:631–40.PubMedPubMedCentralGoogle Scholar
  44. 44.
    Buvanendran A, Kroin K. Multimodal analgesia for controlling acute postoperative pain. Acute Pain. 2009;11(3–4):145–6.  https://doi.org/10.1016/j.acpain.2009.10.006.CrossRefGoogle Scholar
  45. 45.
    Perioperative management. AIDS Institute Clinical Guidelines. https://www.hivguidelines.org/hiv-care/perioperative-management/#tab_2. Accessed 22 Oct 2019.
  46. 46.
    Walubo A. The role of cytochrome P450 in antiretroviral drug interactions. Expert Opin Drug Metab Toxicol. 2007;3(4):583–98.PubMedGoogle Scholar
  47. 47.
    Dekkers BG, Bierman WF, Touw DJ, Alffenaar J-WC. Relevance of the drug-drug interactions between lidocaine and the pharmacokinetic enhancers ritonavir and cobicistat. AIDS. 2019;33(6):1100–2.PubMedPubMedCentralGoogle Scholar
  48. 48.
    Edelman EJ, Gordon KS, Re VL, Skanderson M, Fiellin DA, Justice AC. Acetaminophen receipt among HIV-infected patients with advanced hepatic fibrosis. Pharmacoepidemiol Drug Saf. 2013;22(12):1352–6.PubMedPubMedCentralGoogle Scholar
  49. 49.
    Katzung B, Trevor AJ. Basic and clinical pharmacology. New York: Mcgraw-Hill; 2015.Google Scholar
  50. 50.
    Cambic C, Avram M, Gupta D, Wong C. Effect of ritonavir-induced cytochrome P450 3A4 inhibition on plasma fentanyl concentrations during patient-controlled epidural labor analgesia: a pharmacokinetic simulation. Int J Obstet Anesth. 2014;23(1):45–51.PubMedGoogle Scholar
  51. 51.
    Oluwabukola A, Oluwabukola O. Anaesthetic considerations for the HIV positive parturient. Ann Ib Postgrad Med. 2011;7(1):31–5.Google Scholar
  52. 52.
    Wong EL, Yam CH, Cheung AW, et al. Barriers to effective discharge planning: a qualitative study investigating the perspectives of frontline healthcare professionals. BMC Health Serv Res. 2011;11(1):242.PubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of Cincinnati Medical CenterCincinnatiUSA
  2. 2.Department of Anesthesiology and Pain ManagementUniversity of Cincinnati Medical CenterCincinnatiUSA

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