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Am J Psychiatry 1992; 149:514-520
Copyright © 1992 by American Psychiatric Association
Fatigue, sleep disturbance, disability, and indices of progression of HIV infection
DF Darko, JA McCutchan, DF Kripke, JC Gillin and S Golshan
Department of Psychiatry, University of California, School of Medicine, San Diego.
OBJECTIVE: The authors' objective was to test the hypothesis that fatigue
affects the activities and employment of subjects with HIV infection and
that indices of immunosuppression and inflammation may have statistical
utility in predicting fatigue and sleep disturbance. METHOD: The authors
prospectively asked 112 homosexual men (62 HIV- seropositive subjects and
50 HIV-seronegative comparison subjects) to complete a questionnaire on
fatigue and sleep disturbance. In addition, hematocrit, WBC count, CD4+
cell number, lactate dehydrogenase, albumin, and total globulin were
measured. RESULTS: For HIV- seropositive patients fatigue was significantly
more of a problem and interfered more with important activities such as
employment and driving than with seronegative comparison subjects. The
HIV-infected patients were significantly more likely to be unemployed, to
feel fatigued through more hours of the day, to sleep more, to nap more,
and to have diminished midmorning alertness. The medical variables could be
used to statistically predict fatigue, its interference with daily
activities, and employment. CONCLUSIONS: Fatigue and sleep disturbances
contribute to morbidity and disability in HIV-infected homosexual men,
especially those in CDC stage IV (AIDS-related complex or AIDS).
Correlation with measures of immunosuppression and inflammation and
comparison between fatigued versus nonfatigued groups suggest the
possibility of statistical prediction of fatigue by using these measures.
Further study is needed to examine the possibility of eventual specific
intervention to clinically treat HIV-related fatigue, sleepiness, and sleep
disturbance.
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