What Causes HIV/AIDS-Related Fatigue?
There are many reasons why people with HIV/AIDS experience fatigue. The virus itself, opportunistic infections, drug side effects, poor nutrition – these are only some of the possible causes. Below is more information about some of the most common reasons for HIV/AIDS-related fatigue.
Active HIV Infection
When your HIV infection is active, your body uses its stored energy to fight the invading infectious organisms, or pathogens. Fatigue will set in unless this energy is replenished.1
Other Diseases or Infections
Opportunistic infections, fungal diseases and parasitic diseases are common in people with HIV/AIDS and can cause fatigue. Chronic viral hepatitis, pneumonia caused by Pneumocystis (carinii) jiroveci, Mycobacterium avium complex, cytomegalovirus and toxoplasmosis are some of the diseases and infections that can cause fatigue.
Anemia
Anemia occurs when you don't have enough red blood cells—the cells that carry oxygen to the vital organs and tissues throughout the body—or if these cells aren't carrying enough oxygen. This causes your heart to work harder, which leads to fatigue.
There are many causes of anemia in people with HIV/AIDS. These include opportunistic infections, cancers that impair bone marrow function, inadequate levels of erythropoietin (a hormone that controls red blood cell production) and a lack of essential nutrients, such as iron, vitamin B12 and folic acid. In addition, many medications used to treat HIV and AIDS can cause anemia.2
Hormonal Imbalances
Low levels of hormones, such as testosterone, thyroid hormone and cortisol, can cause fatigue. People with HIV/AIDS may experience hormonal imbalances due to the virus itself or due to opportunistic infections and the drugs used to treat them.3
Medications
Drug side effects are a major cause of fatigue in people with HIV/AIDS. In some cases, fatigue is a side effect of the medications used to treat HIV/AIDS. In other cases, the medications cause anemia or disrupt sleep patterns, leading to fatigue.
Psychological Factors
At some point, many people with HIV/AIDS suffer from depression and experience symptoms such as decreased energy, lack of stamina or a feeling of tiredness all the time.4 It can be difficult to sort out cause and effect when it comes to depression and fatigue: depression can cause fatigue, and the inability to carry out normal activities due to fatigue can lead to depression. Anxiety, common among people with HIV/AIDS, is also associated with fatigue.5
Insomnia/Poor Sleep
Many people with HIV/AIDS have problems sleeping, which can lead to fatigue. Psychological factors, such as depression, anxiety and stress, are common reasons for insomnia. Physical conditions, such as diarrhea or pain, can also disrupt sleep, and some medications and recreational/illegal drugs can lead to poor sleep or insomnia.
Substance Use/Abuse
Caffeine and alcohol can interfere with sleep, as can the use of recreational or illegal drugs.
Malnutrition
Fatigue often affects people who are not maintaining an adequate and healthful diet. In those with HIV/AIDS, the disease itself, symptoms caused by opportunistic infections, and the side effects of medications can result in loss of appetite, nausea, changes in taste, and sores in the mouth or throat. This can make it difficult for people with HIV/AIDS to consume adequate calories and nutrients7, putting them at risk of malnutrition and fatigue.
Lack of Physical Exercise
Physical inactivity can actually cause fatigue, whereas light to moderate exercise has been shown to increase energy. Physical activity also helps to increase muscle mass, reduce stress, regulate sleep patterns and increase the appetite, all of which are beneficial to those with HIV/AIDS.8