Post-print: Diagnosing and treating HIV-associated sensory neuropathy: a global perspective. DOI: 10.2217/pmt.15.65

Abstract: HIV-associated sensory neuropathy (HIV-SN) is a common complication of HIV and remains highly prevalent even with modern HIV management strategies; causing debilitating pain in millions globally. We review HIV-SN diagnosis and management. We suggest most HIV-SN cases are easily recognized using clinical screening tools, with physician assessment and/or specialized testing prioritized for atypical cases. Management aims to prevent further nerve damage and optimize symptom control. Symptom relief is difficult and rarely complete, with a lack of proven pharmacological strategies. Work is needed to clarify optimal use of available medications. This includes understanding the marked placebo effect in HIV- SN analgesic trials and exploring “responder phenotypes”. Limited data support non-drug strategies including hypnosis, meditation, psychology, physical activity, and a positive therapeutic relationship.