Department of Oral Medicine, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia.
Objectives: Neuropathy has been recognized as one of the most common neural complications of HIV. However, despite the benefits of ART, a substantial percentage of treated individuals will experience adverse drug reactions such as sensory neuropathy. Significant pain from HIV-associated sensory neuropathy (HIV-SN) affects 40% of HIV infected individuals treated with antiretroviral therapy (ART). The most salient symptom of the neuropathy is pain, which frequently is moderate to severe in intensity, and has been associated with reduced activities of daily living and physical function, sleep disruption, increased severity of depression and anxiety. The evidence for managing painful HIV-SN is poor. The purpose of the present study was to verify the evidence for the neuropathic complication in HIV/AIDS patients in order to develop effective pain management strategies.
Methods: Design: Systematic review. Data sources: Pubmed, Cochrane, Medline, www.controlled-trials.com. Selection criteria: the filter "English" was used, time framed searched was 2009-2019, randomized controlled trials (RCT). Keywords were verified in MeSH "Peripheral Nervous System Disease" and "Antiretroviral Agents" or "Antiretroviral therapy". Review method: the PRISMA flow chart was used.
Result: A systematic search following PRISMA guidelines was conducted and 12 specific articles/studies on the subject were selected. The results revealed that HIV therapy, aging, body mass index, height and systemic condition influence the neuropathy experienced by patients living with HIV/AIDS. These predisposing factors suggest the need for pain management strategies, such as recommending pain medication, drug combinations to prevent side effects, or giving ART that has minimal side effects.
Conclusion: The reviewed literature suggests that HIV-associated sensory neuropathy is a frequent complication of HIV infection and ART. Understanding the mechanism and pathophysiology causing neuropathy in HIV is required in order to develop alternative treatment modalities and evaluate preventive strategies.
Keywords: Neuropathy, Antiretroviral therapy, HIV/AIDS