Pain syndromes and etiologies in ambulatory AIDS patients Journal Article


Authors: Hewitt, D. J.; McDonald, M.; Portenoy, R. K.; Rosenfeld, B.; Passik, S.; Breitbart, W.
Article Title: Pain syndromes and etiologies in ambulatory AIDS patients
Abstract: Ambulatory AIDS patients participating in a quality of life study were recruited for an assessment of pain syndromes. Of 274 patients with pain, 151 (55%) consented to the assessment which included a clinical interview, neurologic examination, and review of medical records. The number, type, and etiology of pains were evaluated in terms of risk factors, age, sex, CD4+ lymphocyte count, and performance status. The average number of pains per patient was 2.7 (range, 1-7), yielding a total of 405 pains. The most common pain diagnoses were headache (46% of patients; 17% of all pains), joint pain (31% of patients; 12% of pains), pain due to polyneuropathy (28% of patients; 10% of pains), and muscle pain (27% of patients; 12% of pains). Pathophysiology was inferred for all pain syndromes (except for headache), 45% of pain syndromes were somatic in nature, 15% were visceral, 19% were neuropathic, and 4% were unknown, psychogenic, or idiopathic; 17% of pains were classified as headache, hence pathophysiology conld not be determined. Pain resulted from diverse etiologies, including the direct effects of HIV/AIDS-related conditions (30%) pre-existing unrelated conditions (24%), and therapies for HIV/AIDS and related conditions (4%). The latter category, pain related to HIV therapies, occurred in 11% of patients. In 37% of the pains, the etiology could not be determined from the information available. In univariate analyses, lower CD4+ cell counts were significantly associated with polyneuropathy (P < 0.05) and headache (P < 0.05), and female gender was significantly associated with the presence of headache (P < 0.05) and radiculopathy (P < 0.001). These data confirm the diversity of pain syndromes in AIDS patients, clarify the prevalence of common pain types, and suggest associations between specific patient characteristics and pain syndromes. The large proportion of patients who could not be given a diagnosis underscores the need for a careful diagnostic evaluation of pain in this population.
Keywords: adolescent; adult; middle aged; major clinical study; prospective studies; quality of life; pain; syndrome; acquired immune deficiency syndrome; outpatients; health surveys; ambulatory aids patients; humans; human; male; female; priority journal; article
Journal Title: Pain
Volume: 70
Issue: 2-3
ISSN: 0304-3959
Publisher: Elsevier Science BV  
Date Published: 1997-04-01
Start Page: 117
End Page: 123
Language: English
DOI: 10.1016/s0304-3959(96)03281-2
PUBMED: 9150284
PROVIDER: scopus
DOI/URL:
Notes: Article -- Export Date: 17 March 2017 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. William S Breitbart
    505 Breitbart
  2. Steven D Passik
    122 Passik
  3. Russell K. Portenoy
    165 Portenoy