Fatigue in HIV Patients Is Strongly Associated with Psychological
Factors and Not with Advanced Disease or HAART
Fatigue is a commonly voiced concern among
people living with HIV infection and AIDS. The causes of fatigue
in the general population are manifold. In the current study, researchers
sought to describe the prevalence of operationally
defined fatigue in an ethnically diverse HIV-infected population
in south London, and to examine the association of fatigue with
demographic characteristics, stage of disease, antiretroviral
therapy and psychological factors.
A descriptive comparative
cross-sectional study of HIV-infected patients attending a London
HIV clinic over a 5-month period in 2002 was performed. Demographic
and clinical data were obtained from the local database.
Participants
completed four self-administered questionnaires the Chalder Fatigue
Scale (CFS), a measure of physical and mental fatigue; the General
Health Questionnaire (GHQ-12) to detect anxiety and depression;
the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)
to measure functional status, and the Illness Perception Questionnaire
(IPQ).
Fatigue 'cases' were defined
as those scoring at least 4 on the CFS. Multivariate logistic regression
was used to identify factors associated with the presence of fatigue.
Results
·
Two
hundred and five patients were approached and 148 (72%) agreed to
participate.
·
Overall,
65% of patients were defined as fatigued.
·
Significant
psychological distress on the GHQ-12, functional impairment on the
SF-36 and a higher CD4
count
were all independently associated with the presence of fatigue.
·
There
was no association with use of antiretroviral therapy or demographic
characteristics.
Based
on these findings, the study authors conclude, “The presence of
fatigue in HIV-infected patients is most strongly associated with
psychological factors and not with more advanced HIV disease or
the use of highly active antiretroviral therapy. This highlights
the importance of investigation and management of underlying depression and anxiety in patients presenting with fatigue.”
09/21/05
Reference
M
Henderson and others. Fatigue among HIV-infected patients in the
era of highly active antiretroviral therapy. HIV
Medicine 6(5): 347-352.
September 2005.
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