Understanding HIV fatigue

Of the many possible symptoms of HIV infection, fatigue can have a subtle, yet profound, effect on the quality of life. Low energy can make it hard to socialize, exercise, and even carry out everyday tasks.

There are ways to battle HIV fatigue and reclaim some of that lost energy. First, it’s important for a person living with HIV to understand the possible causes of HIV fatigue. Then, they can learn how to minimize its frequency and impact on their day-to-day life.

About HIV

HIV targets the immune system. This results in the immune system being unable to get rid of the virus. HIV attacks and takes over T lymphocytes, also known as T cells, which help the body fight infection and disease. HIV uses those T cells to make copies of itself.

About HIV fatigue

A person living with HIV infection may experience fatigue directly related to the virus. The simple presence of the infection can contribute to fatigue as the body uses energy trying to fight the infection. The virus also uses energy from the T cells when it makes copies of itself.

Fatigue may also be indirectly related to the HIV infection. Indirect causes of HIV fatigue can include:

Learning more about these indirect causes and how to help control them may be the first step in resolving HIV fatigue.

Battling depression

Depression can often accompany HIV infection. Depression can make a person feel sad and drained of energy. Depression can also interfere with eating and sleeping patterns. People with depression are often less likely to exercise, which in turn can leave them feeling even more fatigued.

If a person living with HIV starts to develop symptoms of depression, they should speak to their healthcare provider or a mental health professional. It’s possible to overcome depression with talk therapy and other means that don’t include medications. Alternative therapies, like meditation or yoga, help with depression may also be helpful in treating depression.

Sometimes medication may be an option for HIV fatigue due to depression. There are many psychostimulants that have been found to help, including armodafinil and dextroamphetamine. A study in the journal Psychosomatics found that treatment with the medication armodafinil was able to help improve mood and overcome fatigue in some people with HIV. Armodafinil changes the amounts of certain substances in your brain. The drug is typically used to treat sleepiness in narcolepsy.

Battling insomnia

Insomnia is a condition that makes it difficult to fall asleep or stay asleep. In either case, a poor night’s sleep can leave one dragging the next day. To help battle insomnia, a person with HIV fatigue can try these key tips:

  • Go to sleep and wake up at the same times every day.
  • Keep a sleeping log to track changes in sleeping patterns.
  • Don’t lie in bed awake and anxious. If unable to sleep, move to a different part of your home. Rest until you feel tired enough to try sleeping in your bed again.
  • Try reading. Don’t watch TV or get on your phone or computer.
  • Avoid alcohol right before bed and caffeine late in the afternoon or evening.
  • Keep your room dark and cool, if possible, to create a sleep-friendly environment.

If these recommendations don’t help with sleeping difficulties, a healthcare provider can recommend a sedative or hypnotic medication.

Battling HIV drug side effects

HIV medications are powerful drugs. If a person living with HIV experiences fatigue after starting a new drug regimen, they should consult with their healthcare provider. Trying a different drug or combination of HIV drugs may help.

Changing antiretroviral regimens is a serious undertaking. Changing regimens can increase the risk for developing a resistance to antiretroviral drugs. A person living with HIV should not stop taking their medication without first discussing it with their healthcare provider. Pausing antiretroviral medication can cause HIV infection to become resistant to medication.

If a person feels like their HIV medication may be causing fatigue, they should talk with their healthcare provider. It may be possible to switch to a medication that doesn’t cause this symptom. Be sure to follow the healthcare provider’s instructions to make the switch as safe as possible.

Battling idiopathic HIV fatigue

When the source of fatigue can’t be linked to depression, insomnia, drug reactions, or other causes, it’s said to be idiopathic HIV fatigue. This means the cause of fatigue is unknown.

Idiopathic HIV fatigue is common, but it’s hard to predict. A person living with HIV may experience it at any point in the day, or, they may go days without feeling tired. The use of stimulants such as methylphenidate and dextroamphetamine may be helpful for some people. A healthcare provider may prescribe them for everyday use or just when one first begins to notice fatigue.

Talk to your doctor

Many people living with HIV experience fatigue. There are a host of treatments that may help resolve HIV fatigue. However, to pick the right treatment, it’s important to know the cause. A person living with HIV who is experiencing fatigue should work with their healthcare provider to pin down the specific cause and come up with a successful solution.