Assessment and Management of HIV Distal Sensory Peripheral Neuropathy: Understanding the Symptoms

• Published in: Journal for nurse practitioners 2020-04, Vol.16 (4), p.276-280
• Main Authors: Anastasi, Joyce K., Pakhomova, Anna M.
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; AIDS; Analgesics; Antidepressants; Burning; Cardiovascular disease; Chronic pain; chronic pain management; Comorbidity; complementary therapy; Diabetes; Disability; distal sensory peripheral neuropathy (HIV-DSP); Drug abuse; Health education; Health promotion; HIV; Human immunodeficiency virus; Influence; Interdisciplinary aspects; Marijuana; Mental health; Metabolism; Neurologists; neuropathy assessment; Nurse led care; Nurse led services; Nurse practitioners; Pain management; Patients; people living with HIV/AIDs (PLWH); Peripheral neuropathy; Podiatrists; Polypharmacy; Prescription drugs; Quality of life; Risk assessment; Risk factors; Self report; Sensory stimulation; Symptoms; Teaching; Tuberculosis; Unemployment
• ISSN: 1555-4155; 1878-058X
• DOI: 10.1016/j.nurpra.2019.12.019

Distal sensory peripheral neuropathy (HIV-DSP) affects upwards of 50% of people living with HIV. Causing often debilitating symptoms of tingling, numbness, and burning, HIV-DSP can result in disability, unemployment, and low quality of life. Comorbidities further complicate nursing care, heightening risk of polypharmacy and symptom exacerbation. Therefore, a neurologic sensory assessment, combined with the patient’s self-report of symptoms, can help nurse practitioners visualize, quantify, and understand symptoms. Common pharmacologic interventions include antiepileptics, antidepressants, analgesics, and medical marijuana. The complexity of care for individuals with HIV-DSP merits a comprehensive approach. Implications for practice include interdisciplinary management with neurologists, podiatrists, mental health providers, and nurse-led counseling inclusive of patient safety teaching. •Distal sensory peripheral neuropathy (HIV-DSP) is one of the most common and debilitating neurologic HIV complications for people living with HIV (PLWH).•HIV-DSP affects more than 50% of PLWH.•Symptoms include stabbing, numbness and burning sensation in lower extremities.•There are no United States Food, Drug Administration-approved medications for HIV-DSP.•HIV-DSP may result in disability, unemployment, and impaired quality of life•HIV and comorbidity medications cause a polypharmacy risk.•Some combination antiretroviral therapy cause metabolic disruptions that increase diabetes risk.•The prevalence of PLWH with at least 1 comorbidity is predicted to be 84% in 2030.•Patient’s self-report of symptoms and practitioner’s neurologic evaluations are essential.•Managing neuropathic pain and its sequelae requires interdisciplinary collaboration.•Management includes knowledge of polypharmacy, foot care and safety approaches.