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Chronic Migraine Most Common Headache in HIV/AIDS Patients

HIV severity, but not HIV duration, linked to headache severity, frequency, and disability

FRIDAY, Dec. 9 (HealthDay News) -- Headache is prevalent among patients with HIV/AIDS, with chronic migraine being the most common type of primary headache disorder, according to a study published online Nov. 11 in Headache.

Kale E. Kirkland, Ph.D., from the University of Mississippi in Oxford, and colleagues characterized headache symptoms among patients with HIV/AIDS, and assessed the association between headache and HIV/AIDS disease variables. Headache characteristics and features, consistent with International Classification of Headache Disorders (ICHD)-II diagnostic semiologies, were assessed using a structured headache diagnostic interview of 200 HIV/AIDS patients. Participants also completed two measures of headache-related disability. Patient medical records were reviewed to extract data on prescribed medications, most recent cluster of differentiation (CD4) cell count, date of HIV diagnosis, and possible causes of secondary headache.

The investigators identified 107 patients with headache symptoms. After excluding four cases attributable to secondary causes, the majority of headache symptoms were consistent with characteristics of primary headache disorders. Of these, 15 patients (14.56 percent) met the criteria for episodic or chronic tension-type headache (TTH), and 88 patients (85.44 percent) met the criteria for migraine, most of which fulfilled ICHD-II appendix diagnostic criteria for chronic migraine. A strong association was found between HIV severity, measured by CD4 cell count, and headache severity, frequency, and disability, but not for duration of HIV or number of prescribed antiretrovirals. HIV severity also differentiated migraine from TTH.

"Problematic headache is highly prevalent among patients with HIV/AIDS, most of which conform to the semiology of chronic migraine, although with some atypical features such as bilateral location and pressing/tightening quality," the authors write.

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