Psychological Factors Associated With Painful Versus Non-Painful HIV-Associated Sensory Neuropathy
HIV-associated sensory neuropathy (HIV-SN) is a common, and frequently painful complication of HIV, but factors that determine the presence of pain are unresolved. We investigated: (i) if psychological factors associated with painful (n = 125) versus non-painful HIV-SN (n = 72), and (ii) if pain and psychological factors affected quality of life (QoL). We assessed anxiety and depression using the Hopkins Symptoms Checklist-25. Pain catastrophizing and QoL were assessed using the Pain Catastrophizing Scale and Euroqol-5D, respectively. Presence of neuropathy was detected using the Brief Neuropathy Screening Tool, and pain was characterised using the Wisconsin Brief Pain Questionnaire. Overall, there was a high burden of pain, depression and anxiety in the cohort. None of the psychological variables associated with having painful HIV-SN. Greater depressive symptoms and presence of pain were independently associated with lower QoL. In those participants with painful HIV-SN, greater depressive symptom scores were associated with increased pain intensity. In conclusion, in a cohort with high background levels of psychological dysfunction, psychological factors do not predict the presence of pain, but both depression and presence of pain are associated with poor quality of life.
KeywordsDepression Pain intensity Quality of life Painful HIV-associated sensory neuropathy
The authors wish to thank the patients and staff of the Greenhouse Pharmacy at the Chris-Hani Baragwanath Hospital, and Florence Mtsweni for acting as an interpreter in the study. They are also grateful for the assistance of Mr. Rashid Adam from the Greenhouse Pharmacy. The authors gratefully acknowledge the contribution to this work of the Victorian Operational Infrastructure Support Program received by the Burnet Institute (CLC), the Medical Research Council (MRC) and the TATA Foundation for Doctoral funding (PP) and the Hillel Friedland Trust for Fellowship funding (AW).
Medical Faculty Research Endowment Fund of the University of the Witwatersrand (PP), Medical Research Council of South Africa (PRK), National Research Foundation Rated Researchers Programme (PRK), Victorian Operational Infrastructure Support Program received by the Burnet Institute (CLC), and Developed-Developing Countries Collaborative Research Grant of the International Association for the Study of Pain (CLC, PRK).
Compliance with Ethical Standards
Conflict of interest
All authors (PP, ALW, CLC, ASK and PRK) declare no conflict of interest.
All procedures performed in the study were in accordance with the ethical standards of the Wits Human Research Ethics Committee (Medical) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.
Written informed consent was obtained from all individual participants included in the study.
- 10.Wadley AL, Hendry LM, Kamerman PR, et al. Role of TNF block genetic variants in HIV-associated sensory neuropathy in black Southern Africans. Eur J Hum Genet. 2013;2014(27):1–6.Google Scholar
- 26.Van Sighem A, Gras L, Reiss P, Brinkman K, De Wolf F. Life expectancy of recently diagnosed asymptomatic HIV-infected patients approaches that of uninfected individuals. Wolters Kluwer Heal AIDS. 2010;24:1527–35.Google Scholar
- 33.MAPI. Mapi Research Institute.Linguistic validation process. http://www.mapi-institute.com Accessed 19 May 2011.
- 37.McDonald RP. Test theory: A unified treatment. Test theory A unified Treat. 1999:485.Google Scholar
- 46.R Core Team. R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria; 2014 http://www.R-project.org/.
- 47.Kamil Barto’n. MuMIn: Multi-model inference. R package version 1.10.5. 2014. http://CRAN.R-project.org/package=MuMIn.
- 48.Frank E Harrell Jr. rms: Regression ModelingStrategies.R package version 4.2-1. 2014 http://CRAN.R-project.org/package=rms.
- 52.Thom, RMG. Depression and Anxiety in HIV infected individuals attending HIV treatment facilities at various sites in South Africa: Occurence and related factors. A descriptive-analytic study. 2008 wiredspace.wits.ac.za/bitstream/handle/10539/6939/.Google Scholar