Fatigue among HIV-infected patients in the era of highly active antiretroviral therapy
Fatigue among HIV-infected patients in the era of highly active antiretroviral therapy
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DOI：
10.1111/j.1468-1293.2005.00319.x
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发表时间：
2005-09-01
期刊：
影响因子：
3
通讯作者：
Hotopf, M
中科院分区：
文献类型：
--
作者：
Henderson, M;Safa, F;Hotopf, M
目的描述伦敦南部不同种族的 HIV 感染人群中操作定义的疲劳的患病率，并检查疲劳与人口特征、疾病阶段、抗逆转录病毒治疗和心理因素的关系。方法对 2002 年在伦敦 HIV 诊所就诊的 HIV 感染患者进行了为期 5 个月的描述性比较横断面研究。人口统计和临床数据是从当地数据库获得的。参与者完成了四份自填问卷：查尔德疲劳量表（CFS），衡量身体和精神疲劳的指标；一般健康问卷（GHQ-12）以检测焦虑和抑郁；用于衡量功能状态的医疗结果研究 3 6 项简短健康调查 (SF-36) 和疾病感知问卷 (IPQ)。疲劳病例被定义为 CFS 得分至少为 4 的病例。使用多变量逻辑回归来确定与疲劳存在相关的因素。结果接触了 205 名患者，其中 148 名 (72%) 同意参与。总体而言，65% 的患者被定义为疲劳。 GHQ-12 的显着心理困扰、SF-36 的功能障碍和较高的 CD4 计数均与疲劳的存在独立相关。与抗逆转录病毒治疗的使用或人口统计学特征无关。结论 HIV 感染者的疲劳与心理因素密切相关，而不是与更晚期的 HIV 疾病或使用高效抗逆转录病毒治疗相关。这凸显了调查和管理疲劳患者潜在抑郁和焦虑的重要性。
ObjectiveTo describe the prevalence of operationally defined fatigue in an ethnically diverse HIV-infected population in south London, and to examine the association of fatigue with demographic characteristics, stage of disease, antiretroviral therapy and psychological factors.MethodsA descriptive comparative cross-sectional study of HIV-infected patients attending a London HIV clinic over a 5-month period in 2002 was performed. Demographic and clinical data were obtained from the local database. Participants completed four self-administered questionnaires-the Chalder Fatigue Scale (CFS), a measure of physical and mental fatigue; the General Health Questionnaire (GHQ-12) to detect anxiety and depression; the Medical Outcomes Study 3 6-Item Short-Form Health Survey (SF-36) to measure functional status, and the Illness Perception Questionnaire (IPQ). Fatigue,cases' were defined as those scoring at least 4 on the CFS. Multivariate logistic regression was used to identify factors associated with the presence of fatigue.ResultsTwo hundred and five patients were approached and 148 (72%) agreed to participate. Overall, 65% of patients were defined as fatigued. Significant psychological distress on the GHQ-12, functional impairment on the SF-36 and a higher CD4 count were all independently associated with the presence of fatigue. There was no association with use of antiretroviral therapy or demographic characteristics.ConclusionsThe presence of fatigue in HIV-infected patients is most strongly associated with psychological factors and not with more advanced HIV disease or the use of highly active antiretroviral therapy. This highlights the importance of investigation and management of underlying depression and anxiety in patients presenting with fatigue.