Hepatitis C virus infection and pain sensitivity in patients on methadone or buprenorphine maintenance therapy for opioid use disorders

Judith I. Tsui, Marlene C. Lira, Debbie M. Cheng, Michael R. Winter, Daniel P. Alford, Jane M. Liebschutz, Jianren Mao, Robert R. Edwards, Jeffrey H. Samet

Research output: Contribution to journalArticle

Abstract

Background: Patients with opioid use disorders on opioid agonist therapy (OAT) have lower pain tolerance compared to controls. While chronic viral infections such as HCV and HIV have been associated with chronic pain in this population, no studies have examined their impact on pain sensitivity. Methods: We recruited 106 adults (41 uninfected controls; 40 HCV mono-infected; and 25 HCV/HIV co-infected) on buprenorphine or methadone to assess whether HCV infection (with or without HIV) was associated with increased experimental pain sensitivity and self-reported pain. The primary outcome was cold pain tolerance assessed by cold-pressor test. Secondary outcomes were cold pain thresholds, wind-up ratios to repetitive mechanical stimulation (i.e., temporal summation) and acute and chronic pain. Multivariable regression models evaluated associations between viral infection status and outcomes, adjusting for other factors. Results: No significant differences were detected across groups for primary or secondary outcomes. Adjusted mean cold pain tolerance was 25.7 (uninfected controls) vs. 26.8 (HCV mono-infection) vs. 25.3 (HCV/HIV co-infection) seconds (global p-value = 0.93). Current pain appeared more prevalent among HCV mono-infected (93%) compared to HCV/HIV co-infected participants (76%) and uninfected controls (80%), as did chronic pain (77% vs. 64% vs. 61%, respectively). However, differences were not statistically significant in multivariable models. Conclusion: This study did not detect an association between HCV infection and increased sensitivity to pain among adults with and without HIV who were treated with buprenorphine or methadone for opioid use disorders. Results reinforce that pain and hyperalgesia are common problems in this population.

Original languageEnglish (US)
Pages (from-to)286-292
Number of pages7
JournalDrug and Alcohol Dependence
Volume153
DOIs
StatePublished - Aug 1 2015
Externally publishedYes

Fingerprint

Buprenorphine
Methadone
Virus Diseases
Viruses
Hepacivirus
Opioid Analgesics
Pain
HIV
Chronic Pain
Therapeutics
Infection
Pain Threshold
Hyperalgesia
Acute Pain
Coinfection
Population
HIV Infections

Keywords

  • Chronic pain
  • Hepatitis C
  • HIV
  • Hyperalgesia
  • Opioid-related disorders
  • Pain

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Toxicology
  • Pharmacology
  • Pharmacology (medical)

Cite this

Hepatitis C virus infection and pain sensitivity in patients on methadone or buprenorphine maintenance therapy for opioid use disorders. / Tsui, Judith I.; Lira, Marlene C.; Cheng, Debbie M.; Winter, Michael R.; Alford, Daniel P.; Liebschutz, Jane M.; Mao, Jianren; Edwards, Robert R.; Samet, Jeffrey H.

In: Drug and Alcohol Dependence, Vol. 153, 01.08.2015, p. 286-292.

Research output: Contribution to journalArticle

Tsui, Judith I. ; Lira, Marlene C. ; Cheng, Debbie M. ; Winter, Michael R. ; Alford, Daniel P. ; Liebschutz, Jane M. ; Mao, Jianren ; Edwards, Robert R. ; Samet, Jeffrey H. / Hepatitis C virus infection and pain sensitivity in patients on methadone or buprenorphine maintenance therapy for opioid use disorders. In: Drug and Alcohol Dependence. 2015 ; Vol. 153. pp. 286-292.
@article{478f7d88715345f2b61427ac7e7bc150,
title = "Hepatitis C virus infection and pain sensitivity in patients on methadone or buprenorphine maintenance therapy for opioid use disorders",
abstract = "Background: Patients with opioid use disorders on opioid agonist therapy (OAT) have lower pain tolerance compared to controls. While chronic viral infections such as HCV and HIV have been associated with chronic pain in this population, no studies have examined their impact on pain sensitivity. Methods: We recruited 106 adults (41 uninfected controls; 40 HCV mono-infected; and 25 HCV/HIV co-infected) on buprenorphine or methadone to assess whether HCV infection (with or without HIV) was associated with increased experimental pain sensitivity and self-reported pain. The primary outcome was cold pain tolerance assessed by cold-pressor test. Secondary outcomes were cold pain thresholds, wind-up ratios to repetitive mechanical stimulation (i.e., temporal summation) and acute and chronic pain. Multivariable regression models evaluated associations between viral infection status and outcomes, adjusting for other factors. Results: No significant differences were detected across groups for primary or secondary outcomes. Adjusted mean cold pain tolerance was 25.7 (uninfected controls) vs. 26.8 (HCV mono-infection) vs. 25.3 (HCV/HIV co-infection) seconds (global p-value = 0.93). Current pain appeared more prevalent among HCV mono-infected (93{\%}) compared to HCV/HIV co-infected participants (76{\%}) and uninfected controls (80{\%}), as did chronic pain (77{\%} vs. 64{\%} vs. 61{\%}, respectively). However, differences were not statistically significant in multivariable models. Conclusion: This study did not detect an association between HCV infection and increased sensitivity to pain among adults with and without HIV who were treated with buprenorphine or methadone for opioid use disorders. Results reinforce that pain and hyperalgesia are common problems in this population.",
keywords = "Chronic pain, Hepatitis C, HIV, Hyperalgesia, Opioid-related disorders, Pain",
author = "Tsui, {Judith I.} and Lira, {Marlene C.} and Cheng, {Debbie M.} and Winter, {Michael R.} and Alford, {Daniel P.} and Liebschutz, {Jane M.} and Jianren Mao and Edwards, {Robert R.} and Samet, {Jeffrey H.}",
year = "2015",
month = "8",
day = "1",
doi = "10.1016/j.drugalcdep.2015.05.011",
language = "English (US)",
volume = "153",
pages = "286--292",
journal = "Drug and Alcohol Dependence",
issn = "0376-8716",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Hepatitis C virus infection and pain sensitivity in patients on methadone or buprenorphine maintenance therapy for opioid use disorders

AU - Tsui, Judith I.

AU - Lira, Marlene C.

AU - Cheng, Debbie M.

AU - Winter, Michael R.

AU - Alford, Daniel P.

AU - Liebschutz, Jane M.

AU - Mao, Jianren

AU - Edwards, Robert R.

AU - Samet, Jeffrey H.

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Background: Patients with opioid use disorders on opioid agonist therapy (OAT) have lower pain tolerance compared to controls. While chronic viral infections such as HCV and HIV have been associated with chronic pain in this population, no studies have examined their impact on pain sensitivity. Methods: We recruited 106 adults (41 uninfected controls; 40 HCV mono-infected; and 25 HCV/HIV co-infected) on buprenorphine or methadone to assess whether HCV infection (with or without HIV) was associated with increased experimental pain sensitivity and self-reported pain. The primary outcome was cold pain tolerance assessed by cold-pressor test. Secondary outcomes were cold pain thresholds, wind-up ratios to repetitive mechanical stimulation (i.e., temporal summation) and acute and chronic pain. Multivariable regression models evaluated associations between viral infection status and outcomes, adjusting for other factors. Results: No significant differences were detected across groups for primary or secondary outcomes. Adjusted mean cold pain tolerance was 25.7 (uninfected controls) vs. 26.8 (HCV mono-infection) vs. 25.3 (HCV/HIV co-infection) seconds (global p-value = 0.93). Current pain appeared more prevalent among HCV mono-infected (93%) compared to HCV/HIV co-infected participants (76%) and uninfected controls (80%), as did chronic pain (77% vs. 64% vs. 61%, respectively). However, differences were not statistically significant in multivariable models. Conclusion: This study did not detect an association between HCV infection and increased sensitivity to pain among adults with and without HIV who were treated with buprenorphine or methadone for opioid use disorders. Results reinforce that pain and hyperalgesia are common problems in this population.

AB - Background: Patients with opioid use disorders on opioid agonist therapy (OAT) have lower pain tolerance compared to controls. While chronic viral infections such as HCV and HIV have been associated with chronic pain in this population, no studies have examined their impact on pain sensitivity. Methods: We recruited 106 adults (41 uninfected controls; 40 HCV mono-infected; and 25 HCV/HIV co-infected) on buprenorphine or methadone to assess whether HCV infection (with or without HIV) was associated with increased experimental pain sensitivity and self-reported pain. The primary outcome was cold pain tolerance assessed by cold-pressor test. Secondary outcomes were cold pain thresholds, wind-up ratios to repetitive mechanical stimulation (i.e., temporal summation) and acute and chronic pain. Multivariable regression models evaluated associations between viral infection status and outcomes, adjusting for other factors. Results: No significant differences were detected across groups for primary or secondary outcomes. Adjusted mean cold pain tolerance was 25.7 (uninfected controls) vs. 26.8 (HCV mono-infection) vs. 25.3 (HCV/HIV co-infection) seconds (global p-value = 0.93). Current pain appeared more prevalent among HCV mono-infected (93%) compared to HCV/HIV co-infected participants (76%) and uninfected controls (80%), as did chronic pain (77% vs. 64% vs. 61%, respectively). However, differences were not statistically significant in multivariable models. Conclusion: This study did not detect an association between HCV infection and increased sensitivity to pain among adults with and without HIV who were treated with buprenorphine or methadone for opioid use disorders. Results reinforce that pain and hyperalgesia are common problems in this population.

KW - Chronic pain

KW - Hepatitis C

KW - HIV

KW - Hyperalgesia

KW - Opioid-related disorders

KW - Pain

UR - http://www.scopus.com/inward/record.url?scp=84937639036&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84937639036&partnerID=8YFLogxK

U2 - 10.1016/j.drugalcdep.2015.05.011

DO - 10.1016/j.drugalcdep.2015.05.011

M3 - Article

C2 - 26048638

AN - SCOPUS:84937639036

VL - 153

SP - 286

EP - 292

JO - Drug and Alcohol Dependence

JF - Drug and Alcohol Dependence

SN - 0376-8716

ER -