Toggle Main Menu Toggle Search

Open Access padlockePrints

HIV-associated fatigue in the era of highly active antiretroviral therapy: novel biological mechanisms?

Lookup NU author(s): Dr Brendan Payne, Dr Edmund Ong, Dr Nikhil Premchand, Dr Matthias Schmid, Dr Ulrich Schwab, Professor Julia Newton, Dr David Price

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Abstract

Objective The aim of the study was to determine the prevalence and risk factors for HIV-associated fatigue in the era of highly active antiretroviral therapy (HAART). Methods A cross-sectional survey of 100 stable HIV-infected out-patients was carried out. Severity of fatigue was measured using the Fatigue Impact Scale (FIS). Symptoms of orthostatic intolerance (dysautonomia) were evaluated using the Orthostatic Grading Scale (OGS). Data for HIV-infected patients were compared with those for 166 uninfected controls and 74 patients with chronic fatigue syndrome (CFS)/myalgic encephalomyelitis (encephalopathy) (ME). Results Ninety-one per cent of HIV-infected patients were on HAART and 78% had suppressed plasma HIV viral load (40 HIV-1 RNA copies/mL). Fifty-one per cent of HIV-infected patients reported excessive symptomatic fatigue (FIS40), and 28% reported severe fatigue symptoms (FIS80). The mean FIS score among HIV-infected patients was 50.8 [standard deviation (SD) 41.9] compared with 13.0 (SD 17.6) in uninfected control subjects, and 92.9 (SD 29.0) in CFS patients (P<0.001 for comparison of HIV-infected patients and uninfected controls). Among HIV-infected patients, fatigue severity was not significantly associated with current or nadir CD4 lymphocyte count, HIV plasma viral load, or whether on HAART. Prior dideoxynucleoside analogue (d-drug) exposure (P=0.016) and the presence of clinical lipodystrophy syndrome (P=0.011) were associated with fatigue. Additionally, fatigue severity correlated strongly with symptomatic orthostatic intolerance (r=0.65; P<0.001). Conclusions Fatigue is very common and often severe in HIV-infected out-patients, despite viral suppression and good immune function. In a subgroup of patients, prior d-drug exposure may contribute to fatigue, suggesting a metabolic basis. Dysautonomia may also drive fatigue associated with HIV infection, as in other chronic diseases, and CFS/ME, and should be further evaluated with the potential for a shared therapeutic approach.


Publication metadata

Author(s): Payne BAI, Hateley CL, Ong ELC, Premchand N, Schmid ML, Schwab U, Newton JL, Price DA

Publication type: Article

Publication status: Published

Journal: HIV Medicine

Year: 2013

Volume: 14

Issue: 4

Pages: 247-251

Print publication date: 29/10/2012

ISSN (print): 1464-2662

ISSN (electronic): 1468-1293

Publisher: Wiley-Blackwell Publishing Ltd.

URL: http://dx.doi.org/10.1111/j.1468-1293.2012.01050.x

DOI: 10.1111/j.1468-1293.2012.01050.x


Altmetrics

Altmetrics provided by Altmetric


Actions

Find at Newcastle University icon    Link to this publication


Share