Prevalência de dor crônica em participantes que vivem com HIV: estudo transversal em participantes ambulatoriais de centro universitário de referência no tratamento do HIV em Belo Horizonte

Abstract

ABSTRACT Objective: To assess the prevalence of pain, depression and quality of life in persons living with human immunodeficiency virus/ acquired imunodeficience syndrome (PHIV/AIDS), their interconnections and the level of approach to chronic pain in PLHIV by the medical team specialized in HIV treatment. Methods: 209 patients from the Training and Reference Center for Infectious and Parasitic Diseases (CTR-DIP) of the Belo Horizonte City Hall - Hospital das ClínicasUniversidade Federal de Minas Gerais, CTR-DIP Orestes Diniz, were interviewed. A semi-structured questionnaire with instruments to assess pain, depression, and quality of life was administered. It was also assessed the percentage of patients with chronic pain who discussed their pain with an infectious disease specialist and the interventions performed by the specialist. Demographic data, behaviors such as smoking and alcohol consumption, comorbidities, antiretroviral therapy use, LTCD4+count, and viral load were collected, and descriptive and comparative analyses were performed to assess associations between these variables and the outcome of interest: pain. Results: Of the 209 patients evaluated in this study, 80 (38.3%) had chronic pain, moderate to severe in 66.2%. HIV/ antiretroviral therapy - ART - related neuropathic pain was diagnosed in only 1 patient (0.5%). No association was found between chronic pain and sex, age, weight, education, family income, comorbidities, time since HIV diagnosis, smoking, or alcohol consumption. Fifty-six patients (26.8%) were diagnosed with depression. Among patients with chronic pain, there was a significantly higher comorbidity of depression, 41.3% (p < 0.001). The association of pain and depression in PLHIV significantly worsens the quality of life of these patients (p < 0.05). Of the 78 participants with chronic pain who responded and/or had records in the medical records, 47 patients (60%) had not spontaneously reported or been questioned about pain to the infectious disease specialist. When evaluating the percentage of improvements according to the Brief Pain Inventory (BPI) (last 24 hours) with the medication intervention performed in this short period, 58% of patients reported significant improvement (50 to 100%), and the remaining 42% reported relief of 0 to 40%. Of the 11 patients diagnosed with neuropathic pain of various etiologies, only one patient was being medicated with amitriptyline, and another was self-medicating with oxcarbazepine. Conclusion: The prevalence of chronic pain and depression was higher in PLHIV, and the combination of depression and chronic pain in these patients significantly worsened their quality of life. The prevalence of neuropathic pain, however, was lower than that reported in the literature, marked by a lack of recent studies with this epidemiological data. This may reflect the results of less neurotoxic and early-onset (ART). Chronic pain remains underdiagnosed and undertreated in HIV/AIDS care settings. Keywords: HIV; Peripheral neuropathy; Chronic pain; Quality of life; Depression.