title: Diagnosing and treating HIV-associated sensory neuropathy: a global perspective.
abstract: HIV-associated sensory neuropathy (HIV-SN) is a common complication of HIV and remains highly prevalent even with modern HIV management strategies, causing debilitating pain in millions globally. We review HIV-SN diagnosis and management. We suggest most HIV-SN cases are easily recognized using clinical screening tools, with physician assessment and/or specialized testing prioritized for atypical cases. Management aims to prevent further nerve damage and optimize symptom control. Symptom relief is difficult and rarely complete, with a lack of proven pharmacological strategies. Work is needed to clarify optimal use of available medications. This includes understanding the marked placebo effect in HIV-SN analgesic trials and exploring 'responder phenotypes'. Limited data support nondrug strategies including hypnosis, meditation, psychology, physical activity and a positive therapeutic relationship.
authors.affiliation: Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.|Infectious Diseases Unit, Department of Infectious Diseases, The Alfred Hospital & Burnet Institute, Monash University, Commercial Rd, Melbourne, Victoria 3004, Australia.
authors.forename: Catherine L
authors.initials: CL
authors.lastname: Cherry
authors.affiliation: Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Antonia L
authors.initials: AL
authors.lastname: Wadley
authors.affiliation: Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Kamerman
mesh_terms: D002986:Clinical Trials as Topic; D014943:Global Health; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D009437:Neuralgia / Q000188:drug therapy / Q000628:therapy* / Q000821:virology; D017288:Pain Threshold; D011115:Polyneuropathies / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy* / Q000821:virology
keywords: HIV; neuropathic pain; neuropathy; nondrug strategies; placebo effect