Pain syndromes in HIV infection

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Pain causes considerable disability and discomfort in HIV (Human Immunodeficiency Virus) infected individuals. A large number of patients infected with HIV suffer from one or more pain-related syndromes. Pain is under-reported and suboptimally managed in these patients. An outline of the different pain syndromes, including headache, oral cavity pain, chest pain, abdominal pain, anorectal pain, musculoskeletal pain and peripheral neuropathic pain, and their aetiologies are discussed. Current pain management modalities, including non-narcotic and narcotic analgesics, tricyclic antidepressants, anticonvulsants, physical therapy and psychological techniques, are outlined. Treatment should be based on the same principles applied to the management of cancer-related pain. A multidisciplinary, comprehensive approach to pain management will assist these individuals to achieve improved levels of comfort, function and quality of life in this ultimately terminal illness.


La douleur cause un inconfort et une incapacité considérable chez les individus infectes avec le virus HIV (Human Immunodeficiency Virus). Plusieurs patients infectés avec le virus HIV souffrent d’un ou de plusieurs syndrômes associés à de la douleur. On parle peu de cette douleur chez ces patients et elle est traitée de façon inadéquate. Nous décrivons les différents syndrômes douloureux suivants et discutons de leur étiologie: céphalée, douleur de la cavité orale, douleur thoracique, douleur abdominale, douleur anorectale, douleur musculosquelettique et douleur de neuropathie périphérique. Nous décrivons les modalités thérapeutiques courantes incluant les analgésiques narcotiques et non narcotiques, les antidépresseurs tricycliques, les anticonvulsivants, la physiothérapie et les techniques psychologiques. Le traitement devrait etre fondé sur les mêmes principes que ceux de la douleur reliée au cancer. Une approche compréhensive et multidisciplinaire face au traitement de la douleur aidera ces individus à obtenir un niveau amélioré de confort, de fonctionnement ainsi qu ’une meilleure qualité de vie face à cette maladie terminale.


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Correspondence to A. J. M. Clark.

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Penfold, J., Clark, A.J.M. Pain syndromes in HIV infection. Can J Anaesth 39, 724–730 (1992).

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Key words

  • infection: HIV, AIDS
  • pain: chronic