title: Chronicity and remission of fatigue in patients with established HIV infection.
abstract: Fatigue is one of the most common and debilitating complaints of HIV-positive individuals, potentially leading to important functional limitations. We recruited 128 HIV-positive individuals (fatigued and nonfatigued) between March 2005 and May 2006; 66% were male, 66% were African American, 45% had greater than a high school education, 67% were unemployed, and ages ranged from 26-66 (median, 44). Every 3 months for 15 months, participants completed a 56-item self-report fatigue scale developed and validated by the authors. Participants were classified as fatigued or not fatigued at each assessment and received scores for fatigue intensity and impact of fatigue on functioning. We used linear mixed-effects models to assess longitudinal variation in fatigue scores and generalized estimating equations for binary outcomes to model predictors of fatigue remission among those fatigued at baseline. At baseline, 88% of the sample was fatigued. Fatigue measures were highly correlated across time points (rho 0.63-0.85 [intensity], 0.63-0.80 [functioning]) and showed no evidence of overall improvement, deterioration, or convergence over time. Predictors of lower fatigue scores included higher income, employment, longer time since HIV diagnosis, and antiretroviral therapy use. Those employed at baseline were likely to show improvements in fatigue while those unemployed were not. Of those fatigued at baseline, 11% experienced remission during follow-up; remission was associated with Caucasian race and employment. In summary, fatigue intensity and related functional limitations were persistent, stable, and unlikely to remit over 15 months of follow-up in this sample of patients with established HIV infection.
authors.affiliation: Health Inequalities Program, Center for Health Policy, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina 27705, USA. bpence@aya.yale.edu
authors.forename: Brian Wells
authors.initials: BW
authors.lastname: Pence
authors.forename: Julie
authors.initials: J
authors.lastname: Barroso
authors.forename: James L
authors.initials: JL
authors.lastname: Harmon
authors.forename: Jane
authors.initials: J
authors.lastname: Leserman
authors.forename: Naima
authors.initials: N
authors.lastname: Salahuddin
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Hammill
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005221:Fatigue / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000821:virology; D015497:HIV-1; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors