Pharmacologic and non-pharmacologic treatments for chronic pain in individuals with HIV: a systematic review.
Chronic pain occurs in as many as 85% of individuals with HIV and is associated with substantial functional impairment. Little guidance is available for HIV providers seeking to address their patients' chronic pain. We conducted a systematic review to identify clinical trials and observational studies that examined the impact of pharmacologic or non-pharmacologic interventions on pain and/or functional outcomes among HIV-infected individuals with chronic pain in high-development countries. Eleven studies met inclusion criteria and were mostly low or very low quality. Seven examined pharmacologic interventions (gabapentin, pregabalin, capsaicin, analgesics including opioids) and four examined non-pharmacologic interventions (cognitive behavioral therapy, self-hypnosis, smoked cannabis). The only controlled studies with positive results were of capsaicin and cannabis, and had short-term follow-up (≤12 weeks). Among the seven studies of pharmacologic interventions, five had substantial pharmaceutical industry sponsorship. These findings highlight several important gaps in the HIV/chronic pain literature that require further research.
a Divisions of Infectious Diseases and Gerontology, Geriatrics and Palliative Care , University of Alabama at Birmingham , Birmingham , AL , USA.
Jessica S
JS
Merlin
b Department of Psychology , University of Alabama at Birmingham , Birmingham , AL , USA.
Hailey W
HW
Bulls
c Lister Hill Library, Lister Hill Library of the Health Sciences , University of Alabama at Birmingham , Birmingham , AL , USA.
Lee A
LA
Vucovich
d Department of Internal Medicine , Yale University School of Medicine and Center for Interdisciplinary Research on AIDS, Yale University School of Public Health , New Haven , CT , USA.
E Jennifer
EJ
Edelman
e Division of General Internal Medicine , Albert Einstein College of Medicine and Montefiore Medical Center , Bronx , NY , USA.
Joanna L
JL
Starrels
D000700:Analgesics / Q000627:therapeutic use*; D059350:Chronic Pain / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D006990:Hypnosis; D008385:Marijuana Smoking
D000700:Analgesics
HIV; chronic pain; cognitive therapy; hypnosis; medical marijuana; systematic review