• Judith I Tsui, Marlene C Lira, Debbie M Cheng, Michael R Winter, Daniel P Alford, Jane M Liebschutz, Jianren Mao, Robert R Edwards, and Jeffrey H Samet.
• Section of General Internal Medicine, Department of Medicine, University of Washington School of Medicine, 325 9th Avenue, Seattle, WA 98104, United States. Electronic address: tsuij@uw.edu.
• Drug Alcohol Depend. 2015 Aug 1; 153: 286-92.

BackgroundPatients 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.MethodsWe 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.ResultsNo 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.ConclusionThis 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.Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

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