Physiological Correlates of HIV-Related Fatigue

Abstract

Our primary aim is to describe the relationship of multiple physiological variables and HIV-related fatigue. We report baseline data collected from 128 human immunodeficiency virus (HIV)-positive individuals. The HIV-Related Fatigue Scale was used to measure several aspects of fatigue. Blood was drawn for the following physiological variables: hepatic function, thyroid function, HIV viral load, immunologic function, gonadal function, hematologic function, serum cortisol, and cellular injury. In bivariable analyses, free testosterone (p = 0.03) and CD8 (p = 0.07) were negatively correlated with fatigue intensity, and nonlinear relationships were observed between fatigue intensity and total testosterone (p = 0.02), thyroxine (p = 0.01), hematocrit (p = 0.06), and total bilirubin (p = 0.06). However, none of these associations persisted in multivariable models. It is possible that fatigue suffered by seropositive people is better predicted by other variables, which must be better understood to develop interventions to successfully ameliorate HIV-related fatigue. Keywords HIV-related fatigue; physiological variables; biomarkersNow that treatments are available to prolong the lives of people with human immunodeficiency virus (HIV) infection, symptom management has become an increasingly pressing concern. The most frequent and debilitating complaint of HIV-positive people is fatigue, defined as "awareness of a decreased capacity for physical and/or mental activity due to an imbalance in the availability, utilization, and/or restoration of resources needed to perform activity" (Aaronson et al., 1999, p. 46). Justice, Rabeneck, Hays, Wu, and Bozzette (1999) found fatigue to be the most common symptom among people with HIV infection; fatigue was associated with functional limitation and greater fatigue predicted lower chances of survival. Some researchers speculate that HIV-related fatigue is a result of physiological factors, whereas others argue that it is a function of psychosocial variables. This report focuses on the relationship of physiological variables and HIV-related fatigue.Address all correspondence to Julie Barroso, Duke University School of Nursing, DUMC 3322, Durham, NC 27710, phone: (919) Barroso, Carlson, & Meynell, 2003;Breitbart, McDonald, Rosenfeld, Monkman, & Passik, 1998;Justice et al., 1999;Perkins et al., 1995; Sullivan, Dworkin, & the Adult and Adolescnt Spectrum of HIV Investigators, 2003;Vlahov et al., 1994;Vogl et al., 1999; Voss, 2002). Henderson, Safa, Easterbrook, & Hotopf (2005) actually found greater fatigue in individuals with higher CD4 counts. Some studies found no relationship between fatigue and HIV viral load (Barroso et al., 2003;Ferrando et al., 1998;Sullivan et al., 2003; Voss, 2002), whereas one found greater fatigue with a higher viral load (Simmonds, Novy, & Sandoval, 2005).Other immune abnormalities in HIV infection may influence the development and course of fatigue. Untreated HIV infection generally produces a state of heightened immune activation, as measured ...

Predictors of Depressive and Anxiety Symptoms among African American HIV-positive Women

“…When these stressors are combined with the diagnosis of HIV, there may be an increase in experiencing significant depression and anxiety. Women are often burdened with additional stressors such as single parenthood, caring for children and/or aging parents, work and home responsibilities (Barroso, Pence, Salahuddin, Harmon, & Leserman, 2008).…”

“…Women experience hormonal factors that occur during menstrual cycle changes, pregnancy, miscarriage, postpartum period, pre-menopause, and menopause, all of which may contribute to the increased rate of depression in women (Barroso et al, 2008). Physiological and or genetic factors have also been associated with depressive disorders, and may have impacted the development of depression and anxiety (Barroso et al, 2008).…”

“…Physiological and or genetic factors have also been associated with depressive disorders, and may have impacted the development of depression and anxiety (Barroso et al, 2008). Therefore, it is important that both pregnant and non-pregnant women be included in studies.…”

“…Mood disturbances are the most frequently diagnosed mental health disturbances in the U. S. and more common in persons with chronic disorders such as HIV/AIDS (Barroso et al, 2008; National Institute of Mental Health, n/d). In primary care settings, an estimated 10 to 20% of office visits are related to depressive symptoms or an anxiety-related episode (Hirschfeld, 2001).…”

“…Depressive disorders include a wide range of specific illnesses including major depressive disorder (MDD), dysthymia, and bipolar disorder (Barroso et al, 2008). Depression is considered a major health problem and is one of the leading causes of disability in the United States (R. C. Kessler et al, 2003; R. C. Kessler & Kessler, 2003).…”