Painful Hiv-Associated Sensory Neuropathy

Abstract

SUMMARY Painful HIV-associated sensory neuropathy (HIV-SN) is an early recognized neurological complication of HIV. The introduction of effective HIV treatments saw increased rates of HIV-SN, with some antiretrovirals (notably stavudine) being neurotoxic. Although neurotoxic antiretrovirals are being phased out, the available data suggest that incident HIV-SN will remain common, impairing quality of life, mobility and ability to work. Despite its major clinical importance, the pathogenesis and determinants of pain in HIV-SN are poorly understood, and effective prevention and analgesic strategies are lacking. Here, we review what is known about the rates and risk factors for painful HIV-SN, the laboratory models informing our understanding of neuropathic pain in HIV, and the future clinical and laboratory work needed to fully understand this debilitating condition and provide effective management strategies for those affected.

Financial & competing interests disclosure

CL Cherry is supported by funding from Australia‘s National Health and Medical Research Council and gratefully acknowledges the contribution to this work of the Victorian Operational Infrastructure Support Program received by the Burnet Institute. She has previously received support for HIV-SN related research from CNS Bio Australia, Zymes LLC and Roche Australia. AL Wadley has consulted for Pfizer regarding assessment for HIV-SN. PR Kamerman has received honoraria from Pfizer for educational presentations related to HIV-SN. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

CL Cherry is supported by funding from Australia‘s National Health and Medical Research Council and gratefully acknowledges the contribution to this work of the Victorian Operational Infrastructure Support Program received by the Burnet Institute. She has previously received support for HIV-SN related research from CNS Bio Australia, Zymes LLC and Roche Australia. AL Wadley has consulted for Pfizer regarding assessment for HIV-SN. PR Kamerman has received honoraria from Pfizer for educational presentations related to HIV-SN. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed. No writing assistance was utilized in the production of this manuscript.