Sensory, psychological, and metabolic dysfunction in HIV-associated peripheral neuropathy: A cross-sectional deep profiling study
Author(s)
Type
Journal Article
Abstract
HIV-associated sensory neuropathy (HIV-SN) is a frequent complication of HIV infection and a major source of morbidity. A cross-sectional deep profiling study examining HIV-SN was conducted in people living with HIV in a high resource setting using a battery of measures which included the following: parameters of pain and sensory symptoms (7 day pain diary, Neuropathic Pain Symptom Inventory [NPSI] and Brief Pain Inventory [BPI]), sensory innervation (structured neurological examination, quantitative sensory testing [QST] and intraepidermal nerve fibre density [IENFD]), psychological state (Pain Anxiety Symptoms Scale-20 [PASS-20], Depression Anxiety and Positive Outlook Scale [DAPOS], and Pain Catastrophizing Scale [PCS], insomnia (Insomnia Severity Index [ISI]), and quality of life (Short Form (36) Health Survey [SF-36]). The diagnostic utility of the Brief Peripheral Neuropathy Screen (BPNS), Utah Early Neuropathy Scale (UENS), and Toronto Clinical Scoring System (TCSS) were evaluated. Thirty-six healthy volunteers and 66 HIV infected participants were recruited. A novel triumvirate case definition for HIV-SN was used that required 2 out of 3 of the following: 2 or more abnormal QST findings, reduced IENFD, and signs of a peripheral neuropathy on a structured neurological examination. Of those with HIV, 42% fulfilled the case definition for HIV-SN (n = 28), of whom 75% (n = 21) reported pain. The most frequent QST abnormalities in HIV-SN were loss of function in mechanical and vibration detection. Structured clinical examination was superior to QST or IENFD in HIV-SN diagnosis. HIV-SN participants had higher plasma triglyceride, concentrations depression, anxiety and catastrophizing scores, and prevalence of insomnia than HIV participants without HIV-SN.
Date Issued
2014-09-01
Date Acceptance
2014-06-19
Citation
Pain, 2014, 155 (9), pp.1846-1860
ISSN
0304-3959
Publisher
Lippincott, Williams & Wilkins
Start Page
1846
End Page
1860
Journal / Book Title
Pain
Volume
155
Issue
9
Copyright Statement
2014 The Authors. Published by Elsevier B.V. on behalf of International Association for the Study of
Pain. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).
Pain. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).
Sponsor
Wellcome Trust
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000341873000021&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
RTJ7206471-1
Subjects
Science & Technology
Life Sciences & Biomedicine
Anesthesiology
Clinical Neurology
Neurosciences
Neurosciences & Neurology
Anxiety
Catastrophizing
Depression
Diagnosis
HIV-SN
IENFD
Pain
Phenotyping
QST
Quality of life
Triglycerides
SMALL-FIBER NEUROPATHY
HEALTH SURVEY SF-36
INFECTED PATIENTS
EFNS GUIDELINES
RISK-FACTORS
SKIN BIOPSY
PAIN
VALIDATION
PREVALENCE
DEPRESSION
Publication Status
Published
Date Publish Online
2014-09