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Kate Cherry has had a long standing interest in understanding HIV-SN, a common problem affecting the patients she sees living with HIV infection which causes chronic, disabling neuropathic pain and is very difficult to treat. It negatively impacts on patients' quality of life, mobility and ability to work.
Kate has validated a simple screening tool for detecting patients with HIV-SN in the clinic and has trained colleagues from other centres in the use of this tool so that identical methods can be used to understand the epidemiology of HIV-SN in multiple clinics.
To date, we have examined the rates and risk factors for HIV-SN in populations seeking HIV care in Australia, the USA, South Africa, Indonesia and Malaysia. We have demonstrated that very simple things (such as patient age and height) can be used to predict which patients are at a higher risk, identifying a population to whom preventative strategies can be targeted at no extra cost.
In collaboration with colleagues in Perth (P Price), we have undertaken initial genetic studies suggesting that inflammation may be important in the development of HIV-SN, with possible implications for new treatments for neuropathy in the future.
We are now expanding this work with colleagues in South Africa (P Kamerman) and have formed an international consortium (Australia, South Africa and UK) that hopes to undertake more detailed genetic studies of HIV-SN risk in the future.
We have shown that HIV-SN is very common, affecting around 30 percent of patients living with HIV, even when patients have never been treated with potentially neurotoxic medications. Rates are >40 percent in cohorts where these drugs have been used.
We find patient age, height, ethnicity and choice of antiretroviral drugs (but no hepatitis C - previously suggested as an HIV-SN risk factor) are associated with HIV-SN risk. In addition, genes associated with inflammation may modulate the individual’s risk.
Patricia Price, University of Western Australia (with UWA PhD candidate Constance Chew)
Peter Kamerman, University of Witwatersrand, South Africa (with UW PhD candidate Antonia Wadley)
Andrew Rice and Dave Bennet, London Pain Consortium
Justin McArthur, Johns Hopkins University, USA
Bruce Brew, University of NSW
Evy Yunihastuti, Jakarta, Indonesia
Adeeba Kamarulzaman, Kuala Lumpur, Malaysia
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