- *Emmanuel Ifeanyi Obeagu and **Francisca Ifeoma Osunwanne
- 1Department of Biomedical and Laboratory Science, Africa University, Zimbabwe, 2Department of Haematology and Blood Transfusion Science, Faculty of Medical Laboratory Science, Rivers State University of Science and Technology, Port Harcourt, Rivers State.
- FAR Journal of Advanced Medical Studies (FARJAMS)
Abstract
Chronic pain is a significant and persistent issue for individuals with sickle cell disease (SCD), often caused by recurrent vaso-occlusive crises (VOC), which lead to tissue ischemia and inflammation. For patients co-infected with HIV, the management of chronic pain becomes even more complex due to the additional complications of HIV-related immune dysfunction, neuropathy, and the effects of antiretroviral therapy (ART). This review explores the challenges of managing chronic pain in HIV-positive sickle cell patients, focusing on the interactions between the two diseases and the impact of ART on pain management strategies. The article discusses the pathophysiology of pain in co-infected individuals, the difficulties in choosing appropriate analgesic regimens, and the importance of individualized treatment approaches. The presence of both HIV and SCD in a single patient leads to overlapping pain mechanisms. In SCD, pain is primarily due to ischemia and infarction from sickle-shaped red blood cells, while HIV-related neuropathy further exacerbates pain. Additionally, ART, though essential for viral suppression, can influence pain by contributing to peripheral neuropathy or affecting the effectiveness of analgesic medications. Opioid use, a common strategy for severe pain management in SCD, is complicated in HIV-positive patients due to potential drug interactions with ART, as well as concerns about misuse and opioid-induced hyperalgesia. Thus, managing pain in this population requires careful balancing of treatment options.
