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Pain in pediatric human immunodeficiency virus infection: incidence and characteristics in a single-institution pilot
S Hirschfeld1, H Moss, K Dragisic
1Pediatric Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20904, USA.
Insights
Pain is a common and impactful experience for children with human immunodeficiency virus (HIV) infection. Addressing pain management is crucial for improving the quality of life for these pediatric patients.
Area of Science:
- Pediatric Health
- Infectious Diseases
- Pain Management
Background:
- Children with human immunodeficiency virus (HIV) infection often experience multiple disease-related complications.
- Many of these complications can cause pain, potentially affecting a child's quality of life.
Purpose of the Study:
- To examine the incidence and characteristics of pain perception in children with HIV infection.
- To understand the impact of pain on the lives of these children and their families.
Main Methods:
- A validated questionnaire was used to interview caregivers and children.
- The study surveyed 61 children with HIV infection and 19 children with cancer, along with their caregivers.
Main Results:
- 59% of HIV-infected children and 55% of caregivers reported pain impacting their lives.
- Younger children and girls reported more pain; pain was often in the GI tract or limbs and responded to NSAIDs.
- No correlation was found between pain and disease progression markers (e.g., CD4 counts).
Conclusions:
- Pain is a prevalent issue for children with HIV infection.
- Pain significantly impacts the lives of these children.
- Pain management should be an integral part of comprehensive care for pediatric HIV patients.
Objective:
Children with human immunodeficiency virus (HIV) infection have multiple complications associated with the disease process. Many of these complications are potentially painful and could affect the patient's quality of life. We examined the incidence and characteristics of the perception of pain in a cohort of families with children with HIV infection.
Methodology:
A questionnaire was developed and validated with a cohort of families with children with cancer. In a survey of families at the Pediatric Branch of the National Cancer Institute, 61 children with HIV infection and their care givers, along with 19 children with cancer and their care givers, were interviewed to determine the incidence and impact of pain.
Results:
Fifty-nine percent of the HIV-infected children and 55% of their care givers described pain as a component of their illness that impacted on their lives. Younger children and girls tended to report more pain. There was also a tendency for biological parents to expect and to treat more pain than foster parents, although there was no difference in the incidence of pain that biological and foster parents reported for their children. No differences were found between parents who were HIV positive and those who were not. In addition, no correlations were noted in incidence, expectation, or impact of pain with disease progression or surrogate markers such as CD4 counts. Pain in HIV-infected patients tended to be either in the gastrointestinal tract or limbs and usually responded to nonsteroidal anti-inflammatory therapy. The patients with cancer reported an incidence (47%) and impact of pain similar to those of previously reported studies on pediatric patients with cancer.
Conclusion:
Pain is common among children infected with HIV and can adversely impact on their lives, and its management should be a component of the general care of these patients.