Fatigue & night sweats


Dr. Frascino: I was dx w/ HIV Sep'97. Undetectable VR since Nov'97. Have seen MD every 3months w/labs x 13 yrs: t-cells usually btwn 350-450. Generally great health w/lots of energy. Regular at gym.

Since Jan'11, have been really tired & have night sweats 1-3x/wk(1st time in 13 yrs). Mid-Jan labs: VR undetect, t-cells 228. MD visit: no swollen lymph nodes, spleen, liver, etc. Tested for TB(skin & x-ray normal). T-cells and testosterone tested mid-Feb'11(t-cells 285, testosterone 513). I am still feeling tired & having night sweats at least 1x/week(not as often as Jan.) I get home from work, need a nap & little energy to go the gym. A lean 6'2" 160 lbs, 54 yo. Concerned about lack of energy & night sweats. I would appreciate your thoughts on what I should consider next. Thanks.



There are many potential causes of HIV-associated fatigue. You can read about these in detail in the archives of this forum where you'll find an entire chapter devoted to this topic -- Diagnosing Underlying Causes of Fatigue.

Night sweats are annoying. They could be related to your chronic HIV or be a harbinger of something else going on, such as an unrecognized infection or malignancy. I'll reprint below some information about night sweats from the archives.

Because you noticed the onset of both night sweats and fatigue in January 2011 and these symptoms were associated with a drop in your absolute CD4 count, I would advise you have a thorough evaluation and complete workup for a possible underlying opportunistic process. Your HIV specialist should conduct this evaluation.

If after a thorough evaluation no cause of your fatigue can be determined, a trial of Provigil could be considered. You can read about this and other potential treatments in the archives where you'll find a chapter devoted to treatment of HIV-associated fatigue.

Good luck.

Dr. Bob

sweating a lot? (NIGHT SWEATS, 2011) Mar 16, 2011

Hey Doc,

I need ua help.i was diagnosd HIV+ in 2008 n i had herpes but dey usually cum n go,but my problem is dat i am sweating alot in an abnormal way especialy when i sleep or doing some activ work,do you think i might b having a serious problem or its stress coz i waz rejected by the mother of my child after finding out am +.i am alw depresed,plz hlp!!

	Response from Dr. Frascino


Unfortunately I cannot evaluate the cause of your night sweats over the Internet. Certainly your increased sweating could be caused by anxiety due to your recent problems with the mother of your child. However, there are many other potential causes as well in those of us that are "virally enhanced." See below. I'd recommend you see your HIV specialist for an evaluation.

Good luck.

Dr. Bob

Blowjob (NIGHT SWEATS, 2010) Jan 30, 2010

Hi Doc,

Thanks for the reply. I was the one who asked questions previously using the same title 'Blowjob' . I am not sure if my concerns are valid or not. But, i am having night sweats everyday since third week after my oral(with condom) and this is fourth week i am still having night sweats. i donno what might went wrong(as far as i remember condom didn't break). here are my symptoms: 1st week :- sore throat whole week and fever for one day (used medications) 2nd week :- no issues with fever/sore throat. but, white rash at 4 places on my back 3rd week : white rashes(medium size marks) still present.in mid of third week - few night sweats started everyday (In this week i consulted urologist - he said i don't need to take the test after seeing that rashes ) but, i didn't discuss with him about the sweats 4th week : having Night sweats every day.

I donno if these sweats are because of fear or infection. but, am feeling sad and tensed everyday.

Q1) what are your comments on night sweat - are they related to HIV ? Q2) Are these false symptoms because of my tension/fear.

Q3) where will find more information about Night sweats ?

Q4) do i need to really bother about these sweats ? - Or simply void them and go ahead with my life ?

surprisingly- when i wake up the stay awake for few mins they are gone. i am experiencing sweats daily once in the night.

I will donate sir. I appreciate your help.Thanks

Response from Dr. Frascino


  1. No. They are most likely related to anxiety.

  2. Yes.

  3. See below. Plus, there is much more in the archives. Check it out. And you could always "do a Google!"

  4. a) No.

  5. b) Yes.

Dr. Bob

BlowJob Jan 26, 2010

One unknown lady (massage girl) gave me a blow job with Condom(pink transparent)on for 4 mins- i came in the condom. she then masturbated me on the same condom, after that she removed condom off me rolling upwards ( i doubt her hand touched the head of penis- her hand has saliva since, she used same hand to jerk and remove condom). after 5 mins - she wiped my genitals with hot cloth. Q1) am i in risk of HIV ? Q2) did touching of her fingers(hand) on my penis head put me in risk ? Q3) do i need to get tested. I will donate and appreciate your help.

Response from Dr. Frascino





Your HIV-acquisition risk from your rub-and-tug is nonexistent. Relax Max! All is well, including you.

Thanks for your donation to The Robert James Frascino AIDS Foundation (www.concertedeffort.org). It's warmly appreciated.

Dr. Bob

Night Sweats Jul 12, 2005

Hi Dr. Bob,

How are you keeping? I am now in week 7 of HAART and also acute HIV infection. I have been doing fine until last night I had a fever of 101 for about 5 hours, terrible nausea and vomiting. I felt like the whole process was starting all over again. Then it just stopped. A couple of hours later I went to bed and had the mother of all night sweats. Luckily today the weather is hot here in Holland and can put the mattress out to dry. Now the point of query being I have been getting night sweats most nights since I started haart. I change bed clothes usually twice a night. I have started getting up at 4.00am as I am so fed up of being soaked. If I am really tired I double dose my sleeping meds and manage to get sleep until about 6.00am without waking up during the middle of the night. I know that you get night sweats occassionaly. What I dont know is are the recurring or do they stop and take a holiday or is it just the intitial stage of HIV. If they are recurring or go away and come back I think I will have to invest in a plastic incontinence like sheet as the mattress will be ruined. My poor partner has to put all this. He has been through it all himself before but his night sweats never returned. I am on kaletra,sustiva, videx and epivir. Is it common to have a fever like I had last night whilst still in the acute infection stage whislt on HAART?

Many Thanks

Paddy from Amsterdam

Response from Dr. Frascino

Hi Paddy,

Night sweats!!! They are annoying, aren't they??? Sort of gives a whole new meaning to the term "wet dreams!"

Regarding your fever, it seems to have been an isolated event, lasting only five hours and associated with terrible nausea and vomiting. The acute nature and short duration might indicate it's something as simple as eating your mother-in-law's famous tuna casserole (food poisoning) or a brief intercurrent infection (a 24 hour bug). Could it be your primary HIV infection? Yes, that's possible, but may not be the most likely cause. If the fever returns, I would suggest you see your HIV specialist for an evaluation. The list of potential causes is quite large and ranges from intercurrent infections to drug fever.

Now what about the night sweats? Sweating around the time of a fever is normal. That may have triggered your "mother of all night sweats." The more "typical" recurrent HIV-related night sweats are quite common and can be related to a wide variety of potential causes, including:

  1. hormonal imbalances

  2. chronic infections

  3. tumors

  4. HIV itself and

  5. The body's immune system battling HIV with the added effect of potent antiretroviral drugs onboard.

In most cases, if underlying causes other than HIV itself with or without meds have been ruled out or treated, night sweats are usually temporary and resolve on their own. From time to time they may reappear. As I noted above, if they are associated with fever or other symptoms for that matter you should discuss them with your HIV specialist.

Until they calm down, you can try wearing goggles and flippers to bed. It worked for me.

Good luck.

Dr. Bob

Night Sweats Oct 23, 2008

Hi Bob

  • sorry to impose but I am worried. Been back in Australia from Thailand for over two weeks yet am still having severe night sweats, enough to require a change of shirt; sometimes twice. The sweating started about five days after contact and about the same I returned home. I know the contact I had was more than likely safe - but this sweating has me worried. In addition I had a bad head cold about a week after contact but we had a person with a cold sitting next to us on the plane. The contact itself seemed innocuous - just a normal massage, but I had a sunspot on my leg which had been bleeding and after the polite refusal on "extras" I am concerned the masseuse may have accidentillay or even intentionally (because of my refusal) infected me through the open sunspot. I know the likelyhood is remote but the sweating is starting to worry me greatly. How worried should I be about the sweating? - Thanks AussieMike

Response from Dr. Frascino

Hello Aussie Mike,

I agree a "normal massage" is indeed "innocuous." Your concerns the masseuse intentionally (or accidentally) infected you through a "sunspot" on your leg are irrational.

Night sweats can result form many underlying conditions other than HIV! If you're concerned, see your doctor for a checkup. I do not believe your symptoms are HIV related. If you can't shake your worries, get a single HIV-antibody test at the three-month mark. The results will undoubtedly be negative.

By the way, are you the same Aussie Mike who was worried about night sweats after a trip to Thailand earlier in the year? (See below.) Or is this the beginning of an epidemic of night-sweating, Thailand-visiting Aussie Mikes???

Dr. Bob

Night sweats Jul 9, 2008

I received an assuring response from you around 18 June, (not sure of the specific date as the thread runs out on 20 June). I asked about the risk of hiv transmission after fondling the penis of a ladyboy in Thailand when I had a 2 day old, healing paper cut between my knuckle and nail. You said the risk was essentially non-existant. Since returning home I have had severall nights where I had to change my shirt due to severe sweating. I put this down to a change from the tropics to winter here in Oz and a heavy duvet and some anxiety - and tried to ignore it and follow your advice. However a question about night sweats, answered on 8 July had got me all converned again. I have no other symptoms. I even went out and got a flu shot. So the question is - do you think these night sweats are indicative of anything more than my anxiety and a change of climate? Last sweat was two nights ago, 12 days after returning to Oz. Cheers Aussie Mike.

Response from Dr. Frascino

G'day Mike,

Do I think your night sweats are indicative of anything more than your anxiety and a change of climate? Nope, absofrickinlutely not!

My advice "relax mate, she'll be apples" remains unchanged.

Dr. Bob

Risk from cut finger? Jun 18, 2008

I posed this question already and am hoping you considered it not a problem. Nonetheless I am pretty stressed and would really appreciate your thoughts. Last week I did something really dumb while on holiday here in Thailand. I had a small cut on my big finger between the nail and knuckle which is about 3-4mm long. It was not a deep cut and it just grazed the surface causing some bleeding It was caused by a piece of glass, and it occurred about two and a half days prior to the contact. A bit of Band-aid at the time stopped bleeing quickly and after the two days or so it looked to be healing well. What did I do? Well after a couple of beers I ended up next to a ladyboy and using my right hand fondled her penis for about 4 minutes or so. I am very concerned there may have been some precum in the vicinity and even though my cut would not have been in direct contact with her penis I am so concerned I may have exposed myself to hiv. I am incredibly worried and would very much appreciate your opinion regarding my risk status. By the way I visited your beautiful city of SF from Aussie recently. Great place - great people. Many thanks. Mike

Response from Dr. Frascino

G'day Aussie Mike,

Relax mate! Your HIV risk is essentially nonexistent. If HIV were that easily transmitted, it would have wiped out the planet long ago. There is absolutely no HIV risk from fondling the Mr. /Ms. Happy of a ladyboy or boylady with a 3-4 mm two-and-a-half-day-old, well-healing cut, even if precum were "in the vicinity", but not in direct contact with the cut, OK? You have a greater risk of being gobbled up alive by a crazed Tasmanian devil in heat while shopping on Oxford Street in Sydney than getting HIV from such a non-exposure!

So do relax mate. She'll be apples.

Dr. Bob