Physiological and Psychosocial Factors that Predict HIV-Related Fatigue

Abstract

Fatigue is one of the most common and debilitating symptoms experienced by HIV-infected people. We report the results of our longitudinal analysis of physiological and psychosocial factors that were thought to predict changes in HIV-related fatigue in 128 participants over a 1-year period, in an effort to sort out the complex interplay among a comprehensive set of physiological and psychosocial variables. Physiological measures included hepatic function (aspartate aminotransferase, alanine aminotransferase, gamma glutamyl transpeptidase, alkaline phosphatase, total bilirubin, hepatitis C status), thyroid function (thyroid stimulating hormone, thyroxine), HIV viral load, immunologic function (CD4, CD8, CD4/CD8 ratio, CD16, CD8CD38), gonadal function (testosterone, dehydroepiandrosterone), hematologic function (hemoglobin, hematocrit, serum erythropoietin), and cellular injury (lactic acid). Psychosocial measures included childhood and adult trauma, anxiety, depression, social support, stressful life events, and post-traumatic stress disorder (PTSD). Unemployment, not being on antiretroviral therapy, having fewer years since HIV diagnosis, more childhood trauma, more stressful life events, less social support, and more psychological distress (e.g., PTSD, anxiety and depression) put HIV-infected persons at risk for greater fatigue intensity and fatigue-related impairment in functioning during 1-year follow-up. Physiological variables did not predict greater fatigue. Stressful life events had both direct and indirect effects on fatigue.

Hubungan antara Fatigue, Jumlah CD4, dan Kadar Hemoglobin pada Pasien yang Terinfeksi Human Immunodeficiency Virus (HIV)

“…Beberapa studi juga melaporkan bahwa terdapat beberapa faktor yang dapat mempengaruhi fatigue pada pasien HIV/AIDS seperti faktor personal, fisiologis, psikososial dan situasional (Matilda dkk, 2012;Salahuddin, Barroso, Leserman, Harmon, & Pence, 2009;Barroso, Hammil, Leserman, Salahuddin, Harmon, & Pence, 2010).…”

A 7-item version of the fatigue severity scale has better psychometric properties among HIV-infected adults: an application of a Rasch model

“…Prevalence estimates for fatigue range from 37 to 65% [4][5][6][7]. Several studies of people with HIV have found that fatigue is related to psychosocial factors such as sleep disturbance [4,8], depressive symptoms [9,10], anxiety [9], or post-traumatic stress [11]. Studies of physiological correlates of fatigue report conflicting findings about relationships between fatigue and CD4?…”

“…Studies of physiological correlates of fatigue report conflicting findings about relationships between fatigue and CD4? T-cell count [12,13] or viral load [6,7,11,14,15].…”

Self-Care Behaviors and Activities for Managing HIV-Related Anxiety

“…Physiologic changes include the dysregulation of stress regulation hormones, norepinephrine, and cortisol. Additional changes include a diminished regulation of the immune system, an increase in viral replication, increased severity of fatigue (Barroso et al, 2010), and an impaired response to HIV therapies (Greeson et al, 2008). In a study of 188 outpatients with HIV disease in England, Lampe et al (2010) found that anxiety was strongly predictive of virologic rebound among patients with virologic suppression on combination antiretroviral (ARV) therapies.…”