Lethargy and tiredness is a frequent problem especially in advanced disease. It may be quite debilitating and interfere with the ability to carry on working or other routine activities.

Causes

Apart from the direct effects of HIV, symptoms of fatigue may be due to anaemia, depression and weight loss. Chronic infections such as MAI, which may persist for weeks or months, are an important cause.

If fatigue is accompanied by nausea, tenderness in the abdomen or liver area, weight loss and shortness of breath on nucleoside analogue treatment, these symptoms suggest a build-up of lactate, which may develop into lactic acidosis if not treated immediately. See Lactic acidosis in Symptoms and illnesses: A to Z of illnesses for further details.

What to do

Treatment of underlying medical problems such as anaemia, depression or infections such as MAI may help. If the fatigue is due to HIV and is debilitating then starting or changing your anti-HIV treatment may help.

Practical help with routine daily tasks may be needed. Such help is available from local social services or voluntary HIV/AIDS agencies.

Decisions about when to give up work and to accept help in your home are difficult as they alter your sense of independence. Specialist HIV/AIDS social workers, counsellors and advice workers can help you in this decision making and try and provide you with a range of services that suit your needs but continues to respect your independence.

See also: Anaemia