HIV and fatigue – is there a role for physiotherapists?

Abstract

Background: Fatigue has been identified as one of the most common and most bothersome symptoms of HIV. It is prevalent at all stages of the disease, although the exact aetiology remains unclear. Yet as current treatment for HIV allow for longer, healthier lives, the management of its long-term symptoms has become important.Objectives: The purpose of this article was to review the recent research on HIV and fatigue across the life span and to describe current knowledge on the causes and treatment of fatigue in people living with HIV.Major findings: Despite great improvements in the medical management of HIV with combination antiretroviral therapy 95% of individuals infected with HIV still experience very high levels of fatigue. The causes of fatigue in HIV are multifactorial, with physiological, sociodemographic and psychological factors all playing a role. Although fatigue affects both adults and children living with HIV, there is a paucity of research on fatigue in the paediatric population.The assessment and management of fatigue is complex given the interplay between its contributing factors. However, antidepressants, exercise and relaxation techniques all hold promise in the management of HIV-related fatigue.Conclusions: Fatigue is one of the main concerns of people living with HIV. More research is needed to identify the causes of fatigue and effective treatment modalities in this population. Holistic assessment and multi-disciplinary intervention strategies are needed in order to better meet the needs of people living with HIV as they live longer, healthier lives.