Symptoms common in people with HIV
With effective HIV treatment, many people with HIV can look forward to living a long and healthy life.
But researchers have found that symptoms are still common in people with HIV.
Symptoms can lower quality of life, or be a warning that a person has an illness. Despite their importance, researchers have found that symptoms are rarely recognised by doctors.
The researchers looked at a study conducted in the US between 1999 and 2000, which included 750 HIV-positive adults.
They were asked to say if they had experienced common symptoms that are seen in people with HIV and, if so, to say how severe these were and how they affected their quality of life
On the same day, the patient’s healthcare provider also completed a questionnaire, saying if he or she had reported any symptoms in the previous four weeks.
Fatigue was reported by 70% of patients, and difficulty sleeping, depression, muscle aches, and diarrhoea each reported by 60%. Other commonly reported symptoms were headache, difficulty remembering, tingling hands or feet, weight loss, and change in body shape, each being present in 50% or more of patients.
Many symptoms were associated with a poorer quality of life, and weight loss was associated with an increased risk of being admitted to hospital.
But patients who reported having diarrhoea had a lower risk of death than those who did not report this symptom. The researchers think that this is because diarrhoea was a side-effect of the anti-HIV drugs used at this time. Treatments commonly used today are generally easier to tolerate than those used in the 1990s, but some side-effects do still occur in some people.
Side-effects can not only lower quality of life, but can also mean that a person is less likely to take their treatment properly, say the researchers.
It’s therefore important to let your doctor know if you are experiencing treatment side-effects, or any other symptoms.
Reporting symptoms is especially important as the researchers found that healthcare providers rarely recognised that their patients were experiencing symptoms.
Fatigue common in people with HIV
Fatigue was the most commonly reported symptom in the US research reported above. The patients in this study were far from being alone in experiencing this symptom.
Fatigue involves a reduced ability to engage with everyday tasks, and is often accompanied by tiredness that isn’t relieved by a good night’s sleep.
Dutch researchers analysed 42 different studies conducted between 1996 and 2008 to see how common fatigue was in people with HIV; what it’s caused by; and how it’s best treated.
They found that fatigue was very common – in one study it was reported by 88% of patients.
Poverty and a low income were both associated with fatigue, as were emotional and mental health problems.
Perhaps surprisingly, there was no consistent evidence that HIV-related factors, such as high viral load or low CD4 cell count, were associated with an increased risk of fatigue.
However, they did find that symptoms such as fever and stomach problems were often accompanied by fatigue.
Although a wide range of medicines were used to treat fatigue, there was no real evidence that they had much effect.
But the researchers did find that counselling sometimes helped.
Nutritional supplements and HIV
When people experience a symptom such as fatigue, or feel unwell, they sometimes take vitamins or other nutritional supplements.
Both the studies were conducted in areas where malnutrition is common.
The first study involved HIV-positive adults in southern India. This showed that taking a nutritional supplement that provided additional calories, protein and fat did not have any significant benefits.
The second study was conducted amongst HIV-positive infants in Uganda. This showed that doubling the standard dose of vitamin and minerals didn’t reduce the risk of dying, or increase weight or CD4 cell count.
Anal cancer
Researchers have found that pre-cancerous cell changes are sometime hidden in anal warts.
Human papillomavirus (HPV) is a very common infection. Some types can be spread sexually and can cause genital warts.
But some other types of HPV, such as HPV-16 and HPV-18, can cause cell changes that can lead to anal cancer.
US researchers have now found that pre-cancerous cell changes are often “hidden” in seemingly benign anal warts.
They examined tissue removed from gay men suffering from anal warts.
The researchers detected pre-cancerous cell changes in 34% of the samples.
HIV-positive men were more likely to have pre-cancerous cells than HIV-negative men (47 vs 26%).
Anal cancer was detected in eight men, and seven were HIV-positive.
Pre-cancerous cell changes in the anus can be treated, and this treatment has a greater chance of success the sooner it is provided.
Therefore, the researchers believe that seemingly benign anal warts should be checked for pre-cancerous cells. They suggest that the best way to do this is for a small sample of tissue to be removed (a biopsy), and for this to be analysed in the lab.