FATIGUE IN AMBULATORY AIDS PATIENTS

Although preliminary reports indicate that fatigue is a common symptom of human immunodeficiency virus (HIV) disease little empirical resear ch has focused on its prevalence or characteristics among patients wit h acquired immunodeficiency syndrome (AIDS). We assessed the frequency of fatigue, and its medical and psychological correlates, in a cross- sectional survey of ambulatory AIDS patients. Ambulatory patients with AIDS who participated in a study of quality of life (N = 427) were cl assified into fatigue/no fatigue groups based on their responses to fa tigue items on the Memorial Symptom Assessment Scale (MSAS) and the AI DS physical symptom checklist. Self-report inventories were also admin istered to assess psychological distress, depressive symptoms, and ove rall quality of life. Medical information was elicited through clinica l interview and review of medical chart. Fifty-four percent of the pat ients endorsed both of the fatigue items fi-om the MSAS and the AIDS p hysical symptom checklists, and were classified as having fatigue. Wom en were significantly more likely to report fatigue than men (chi squa re = 5.28, df = I, P < 0.03), and patients reporting homosexual contac t as their transmission risk factor were significantly less likely to report fatigue than were patients reporting injection drug rise or het erosexual contact (chi square = 5.13, df = 2, P < 0.03). The presence of fatigue was significantly associated with the number of current AID S-related physical symptoms [t(425) = 8.00, P < 0.0001], current treat ment for HIV-related medical disorders (chi square = 12.51, df = I, P < 0.0001), anemia [t(174) = -2.35, P < 0.02], and pain (chi square = 3 6.36, df = 1 P < 0.0001). Patients with fatigue also had significantly poorer physical functioning ability [Karnofsky: t(422) = -6.27, P < 0 .0001], as well as greater degree of overall psychological distress an d lower quaity of life [F (5,418) = 23.79, P < 0.0001], as measured by the Brief Symptom Inventory, Beck Depression Inventory, Beck Hopeless ness Scale, Functional Living Inventory for Cancer (modified for AIDS) , and the MSAS Psychological Distress Subscale. Fatigue is a common sy mptom in ambulatory AIDS patients and is associated with significant p hysical and psychological morbidity. (C) U.S. Cancer Pain Relief Commi ttee, 1998.