Clinical Aspects of Headache in HIV

Authors

  • Huma U. Sheikh MD,

    1. Department of Neurology, Harvard Medical School, John Graham Headache Center, Brigham and Women's Faulkner Hospital, Boston, MA, USA
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  • Tracey A. Cho MD

    Corresponding author
    1. Department of Neurology, Harvard Medical School, Neurology-Infectious Diseases Program, Massachusetts General Hospital, Boston, MA, USA
    • Address all correspondence to T.A. Cho, Department of Neurology, Harvard Medical School, Neurology-Infectious Diseases Program, Massachusetts General Hospital, 55 Fruit Street, Boston, MA, 02114, USA.

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  • Conflict of Interest: None.

Abstract

Background

Headaches are commonly seen in those patients with human immunodeficiency virus (HIV) and are the most common form of pain reported among HIV patients. There have been relatively few studies attempting to determine the rates and phenotypes of the headaches that occur in patients with HIV.

Discussion

Patients with HIV are susceptible to a much broader array of secondary headache causes, sometimes with atypical manifestations due to a dampened inflammatory response. The investigation of a headache in the HIV patient should be thorough and focused on making sure that secondary and HIV-specific causes are either ruled out or treated if present.

Conclusion

An effective treatment plan should incorporate the use of appropriate pharmacological agents along with the integration of non-pharmacological therapies, such as relaxation and lifestyle regulation. When treating for headaches in patients with HIV, it is important to keep in mind comorbidities and other medications, especially combination antiretroviral therapy. For those with complicated headache histories, referral to a specialized headache center may be appropriate.

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