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Fatigue
Fatigue is common amongst people with HIV. There are many possible causes and treatments and action can be taken to remedy fatigue.
HIV as a cause of fatigue
HIV is a chronic (long-term) infection and the body mounts a strong immune response against it. People with HIV may use a lot of energy because they are constantly battling the virus, so fatigue may slowly develop as a consequence of HIV itself.
High viral load is particularly associated with fatigue. Taking anti-HIV therapy often slows HIV production in the body and many people have more energy after taking anti-HIV drugs.
HIV-related medications and fatigue
Even though anti-HIV drugs may improve energy levels, some may also cause fatigue, especially in the first few weeks of therapy.
If you suspect one of your anti-HIV drugs is causing fatigue, a change in treatment may help. First, rule out other causes of fatigue and discuss your treatment options with your doctor
Drugs used to treat opportunistic infections (such as co-trimoxazole, dapsone and pyrimethamine used to treat PCP and toxoplasmosis, and ganciclovir used to treat CMV) may also cause fatigue. Folinic acid may be taken as treatment.
If your fatigue is due to drug treatment, and you can't stop taking the problem drug, you can be treated with a blood transfusion. This gives you a quick burst of red blood cells, but it is not a long-term solution. Transfusions have a number of disadvantages such as the transmission of infections including CMV. Another short-term option may be injections of a synthetic hormone called erythropoietin which stimulates the production of red blood cells.
Vitamin and mineral deficiencies
Fatigue may be caused by low levels of certain vitamins and minerals. A nourishing, balanced diet may reduce fatigue. Consult an HIV dietitian about minimising fatigue through dietary changes and supplements. For further information see NAM's Nutrition booklet.
Even if you are eating well, you may not be absorbing the goodness from the food you eat due to diarrhoea, stomach bugs or opportunistic infections. Your doctor can investigate and treat the cause of vitamin and mineral deficiencies.
Sleep, stress and depression
Fatigue may be a consequence of disrupted sleep patterns. You may want to establish a routine that balances work, relaxation, sleep and socialising. Consider complementary therapies such as massage or acupuncture to relieve anxiety or fatigue. Reducing your intake of coffee, alcohol and recreational drugs may also reduce fatigue.
Stress and depression may cause fatigue. Consult your doctor about medication or counselling.
Other medical causes of fatigue
Some opportunistic infections (e.g. MAI and TB) and cancers can lead to fatigue and chronic pain. Treatment should be directed at the infection.
Low levels of testosterone may cause fatigue. Steroids may be used to give you energy and build muscles, in conjunction with regular exercise.
Other action to reduce fatigue
You can take action to enhance your energy levels. Moderate exercise improves energy levels and immune function, so you may consider an appropriate exercise routine. Re-organising at home and work may save your energy e.g. put items within easy reach, sit while preparing meals.