The Body Covers: The XIII International AIDS Conference
Incidence and associations of fatigue in HIV-infected persons (Poster, WePeC4462)
July 12, 2000
This study conducted by the CDC sought to trace the causes of fatigue in HIV patients and the effect it has on antiretroviral therapy. The investigators wanted to delve deeper into a condition experienced by many that has a detrimental impact on quality of life and may hinder proper adherence to medication schedules.
The authors did not conduct a new trial to find answers, rather they analyzed data from a previously enacted medical record review project which pooled information from the medical records of 17,630 HIV-infected patients in 10 U.S. cities. Their interest was in correlating the fatigue rate among this population with certain physical/mental conditions and demographic segments.
It was determined that the fatigue rate among this sizable group of HIV patients was 23.0/100 person years (PY). This number becomes more interesting when broken down by disease state: For those who had been diagnosed with AIDS-defining opportunistic infections the rate was well above the average, at 49.6/100 PY; also at a high rate were those with immunologic AIDS (31/100 PY). These are in great contrast to those with no AIDS diagnosis who were significantly below the overall fatigue rate at 14.1/100 PY. It is clear that disease progression plays a prominent role in incidence of fatigue.
Through regression analysis (n=10,725), the investigators also ascertained that fatigue rate was significantly higher in black patients, patients over 45 years of age, and those diagnosed with depression. In addition, levels of hemoglobin were directly linked to fatigue, with higher hemoglobin levels leading to reduced fatigue.
The study does not really break any new ground in understanding the causes of fatigue. Disease progression is a major indicator, but anemia and depression also factor heavily into the incidence of fatigue. The authors point out that other diseases, such as malaria, may make patients more susceptible to fatigue due to already reduced hemoglobin levels in the blood.
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