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Fatigue and AnemiaFatigue and Anemia
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Feb 2, 2004

Hi there for about a week now i have realised i get too tired and when i lay down to take a nap i get up 6 hours later; to these regards when i cannot rest when i am tired i ahve terible headaches my CD4 is 280 and VR 55000 but my dr. does not want me to take medication can you tell me

Response from Dr. Frascino


Fatigue in the setting of HIV disease is very common and may be related to many causes, including:

1. Inadequate or insufficient rest, sleep, exercise, and/or diet.

2. Psychological problems anxiety, depression, stress, guilt, etc.

3. Unrecognized infection(s).

4. HIV itself.

5. Hormonal problems adrenal insufficiency, hypogonadism, low thyroid hormones.

6.Medication side effects.


In your case, the fatigue and headaches may be related. Conditions linking both symptoms could include certain infections or anemia. Your HIV specialist should evaluate you for these and a variety of other potential causes for your symptoms.

Are you seeing an HIV/AIDS specialist? If not, you certainly should be. I'm a bit concerned that your doctor is reluctant to consider starting you on medication, considering you are becoming symptomatic, have a viral load over 50,000, and a CD4 count of only 280. You definitely meet the published guidelines for starting therapy. Perhaps it's time to consider getting a second opinion from another HIV/AIDS expert? If you are writing from the U.S., a list of certified HIV/AIDS experts in your area can be found by checking the American Academy of HIV Medicine website (

Good luck. Write back if you need additional information or advice.

Dr. Bob

don't you ever go nuts. waiting for some improvement!
Drop in CD4, low VL

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