Correlates of fatigue in HIV disease

Management of fatigue is complicated because it is both a side effect of ARV therapy as well as an underlying symptom associated with HIV disease. It is widely reported outside of HIV care by 90% patients visiting GPs and therefore also easily dismissed as a factor that patients have to learn to live with.

Rarely researched, it is therefore worth reporting results from a small study by K Phillips from University of South Carolina which looked at how often variance in fatigue could be explained by anaemia, or by other factors including sleep quality, daytime sleepiness, anxiety, depression and stress.

Correlates of fatigue were examined in a sample (n=57) of individuals from a community clinic (84% single; 89% African-American; 60% female, with mean age of 31). The mean fatigue score of the group was 4.0, one third of whom were found to be anaemic.

The abstract reported relationships between the study variables using Pearson’s r between fatigue and sleep quality (r = 0.50), depression (r = 0.67), trait anxiety (r = 0.56), state anxiety (r = 0.70), and stress (r = 0.75); all highly significant with a p value = 0.0001. Subsequently, these variables were entered into a back stepwise selection model. Sleep quality and perceived stress were the only variables left in the final model that explained 61% of the variance in fatigue.

The study concluded that while anaemia needs to be corrected when identified in HIV-infected individuals, other factors might significantly contribute to fatigue. Sleep quality and stress need to be addressed by clinicians when treating individuals suffering from fatigue.

KD Phillips, RL Sowell, M Rojas et al. Correlates of fatigue in HIV disease. XIV International AIDS Conference, 7-12 July 2002, Seville. Abstract MoPeB3200.