Pain and Physical and Psychological Symptoms in Ambulatory HIV Patients in the Current Treatment Era

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• 作者：Jessica S. Merlin ; MD ; MBA^a ; ^{jessicasarahmerlin@gmail.com} ; Liyi Cen ; MS^b ; Amy Praestgaard ; MS^b ; Michelle Turner ; MS^a ; Aura Obando ; MD^a ; Craig Alpert ; MD^a ; Sophie Woolston ; MD^a ; David Casarett ; MD ; MA^c ; Jay Kostman ; MD^a ; Robert Gross ; MD ; MSCE^a ; ^b ; Ian Frank ; MD^a
• 关键词：HIV ; pain ; symptoms
• 刊名：Journal of Pain and Symptom Management
• 出版年：2012
• 出版时间：March 2012
• 年：2012
• 卷：43
• 期：3
• 页码：638-645
• 全文大小：98 K

文摘

Context

HIV infection has become a manageable chronic disease. There are few studies of pain and symptoms in the current treatment era.

Objectives

Our primary objective was to determine the prevalence of and risk factors for pain and physical and psychological symptoms in a population of ambulatory HIV patients.

Methods

We performed a cross-sectional study using the Brief Pain Inventory and the Memorial Symptom Assessment Scale-Short Form (MSAS).

Results

We evaluated 156 individuals with a median age of 47.5 years (range 21-71), median time since HIV diagnosis of 11 years (range <1 to 25), and median CD4+ cell count of 502 cells/mm³ (interquartile range [IQR] 308-683). Most (125, 80.6 % ) of the patients had an undetectable viral load. Seventy-six (48.7 % ) patients reported pain, of whom 39 (51.3 % ) had moderate to severe pain, and 43 (57.3 % ) had pain that caused moderate to severe interference with their lives. The median number of symptoms was eight (IQR 5-14.5) of 32 queried. In multivariable analyses, patients with psychiatric illness were 39.8 % more likely to have pain (P < 0.001). Psychiatric illness was associated with 0.7 and 1.2 point higher MSAS subscale scores, and IV drug use was associated with 0.4 and 0.5 higher subscale scores (out of four).

Conclusion

Pain and other physical and psychological symptoms were common among ambulatory HIV patients. Pain and symptoms were strongly associated with psychiatric illness and IV drug use. Future investigation should evaluate interventions that include psychiatric and substance abuse components for HIV patients with pain.