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Diagnosing and treating HIV-associated sensory neuropathy: a global perspective.

Cherry CL, Wadley AL, Kamerman PR

  • Journal Pain management

  • Published 18 Mar 2016

  • Volume 6

  • ISSUE 2

  • Pagination 191-9

  • DOI 10.2217/pmt.15.65


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.