The Connection Between Migraine and HIV

I was diagnosed with chronic migraine in 2009. Since then, I have tried a variety of treatment options. These treatments range from medications to procedures and alternative approaches. Unfortunately, none of these treatments helped to reduce the frequency of my migraine attacks.

My HIV diagnosis did not come until the end of 2016 - almost 8 years later. When I was diagnosed, I had a CD4 count of 5, which increased to 35 when my PCP pneumonia was cured. The doctors estimated that I acquired HIV around the same time that my chronic migraine started. I wondered if there was a connection between migraine and HIV/AIDS which launched me into a deep dive into the available research.

HIV/AIDS and migraine study

A study performed at the University of Mississippi evaluated the connection between HIV/AIDS and headaches. This study assessed 200 patients with HIV/AIDS and it found that:²

• 53.5 percent reported headache
• More than 85 percent of those people met the criteria for migraine
• 27.5 percent met the criteria for chronic migraine

The findings speak volumes. These numbers translates into a 13-fold increased risk of chronic migraine among patients with HIV disease.²

Chronic migraine

In the previously mentioned statistics, a group of individuals who met the criteria for migraine also met the criteria for chronic migraine. Chronic migraine is defined as a headache, with migraine features, occurring on 15 or more days per month for more than 3 months.³

As seen in the reviewed study, individuals may have migraine without having chronic migraine, this is considered episodic migraine. In the general population, migraine occurs in about 12 percent of the population and chronic migraine occurs in about 3 to 5 percent of the population. These numbers are way lower than the numbers in the HIV/AIDS study group.³

A possible exception?

Most of the research has shown a link between HIV disease and migraine. These studies tend to show the strongest predictor of headache was the severity of HIV disease, such that patients with more advanced disease had more frequent, more severe and more disabling migraines.²

Logically, one would think this would mean that as the severity of HIV disease decreased, the migraine would as well. But my HIV disease is now under control (with a CD4 count above 500!), but my migraine is still chronic.

Migraine management

For the most part, treating migraine is a constant process. The many preventative and rescue medications that would be used to treat migraine in the general population can also be used to treat migraine in HIV-infected individuals.¹

Creating a migraine management plan also remains the same. This means that the same principles of education, modifying risk factors, abortive treatment, prophylactic treatment, and developing a treatment plan agreeable to both patient and physician apply.¹

Do you live with migraine? If so, is it something that started after you acquired HIV or have you always lived with migraine?