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We determined how these conditions evolved, what factors influenced their evolution, and their clinical impact.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Ambulatory, community\u2010dwelling HIV seropositive individuals were recruited at six research centers. Clinical evaluations at baseline and 12\u00a0years later determined neuropathy signs and distal neuropathic pain (DNP). Additional assessments measured activities of daily living and quality of life (QOL). Factors potentially associated with DSP and DNP progression included disease severity, treatment, demographics, and co\u2010morbidities. Adjusted odds ratios were calculated for follow\u2010up neuropathy outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 254 participants, 21.3% were women, 57.5% were non\u2010white. Mean baseline age was 43.5\u00a0years. Polyneuropathy prevalence increased from 25.7% to 43.7%. Of 173 participants initially pain\u2010free, 42 (24.3%) had incident neuropathic pain. Baseline risk factors for incident pain included unemployment (OR [95% CI], 5.86 [1.97, 17.4]) and higher baseline body mass index (BMI) (1.78 [1.03, 3.19] per 10\u2010units). Participants with neuropathic pain at follow\u2010up had significantly worse QOL and greater dependence in activities of daily living than those who remained pain\u2010free.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>HIV DSP and neuropathic pain increased in prevalence and severity over 12\u00a0years despite high rates of viral suppression. The high burden of neuropathy included disability and poor life quality. However, substantial numbers remained pain\u2010free despite clear evidence of neuropathy on exam. Protective factors included being employed and having a lower BMI. Implications for clinical practice include promotion of lifestyle changes affecting reversible risk factors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51097","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T18:23:56Z","timestamp":1593800636000},"page":"1166-1173","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Predictors of worsening neuropathy and neuropathic pain after 12 years in people with HIV"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4931-752X","authenticated-orcid":false,"given":"Ronald J.","family":"Ellis","sequence":"first","affiliation":[{"name":"Departments of Neurosciences and Psychiatry University of California, San Diego La Jolla California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monica","family":"Diaz","sequence":"additional","affiliation":[{"name":"Department of Medicine University of 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