Distress is positively associated with induced secondary hyperalgesia in people with suppressed HIV.

Abstract

Pain and distress are frequently reported by people with HIV. Although pain is widely acknowledged to contribute to distress, distress may also contribute to pain and its persistence. Given the evidence supporting a relationship between distress and clinical pain, the current study investigated the relationships between distress, secondary hyperalgesia (SH), and persistent pain in people with HIV, reporting pain (n=19) or being pain free (n=26). We anticipated that SH is an important link between distress and persistent pain, with distress potentially exacerbating pain by increasing the responsiveness of neurons in the central nervous system to nociceptive signalling. Our primary hypothesis was that self-reported distress would be positively associated with the induced surface area (primary measure) and magnitude (secondary measure) of SH. The secondary hypothesis was that individuals with persistent pain would display greater induced SH compared to those who reported being pain-free. The results showed that distress was positively associated with the surface area (p=0.02) and the magnitude (p=0.01) of induced SH. However, participants with persistent pain showed no difference in the surface area of SH compared to pain-free participants (p=0.87), and those with pain displayed a marginally lower magnitude of SH (p=0.05). These findings suggest that distress may be a worthy target of interventions in people exposed to acutely painful events. While this relationship may not be specific to people with HIV, further research is needed to establish its relevance to people without HIV.