FATIGUE AND PHYSICAL HOUSEHOLD ACTIVITY IN PEOPLE LIVING WITH HIV
The most common symptom in people who live with HIV (PLHIV) is fatigue. From 33% to 88% of patients suffer from fatigue, which adversely affects their performance, daily functioning and quality of life. The eiology of fatigue in PLHIV remains unknown. Factors that affect fatigue in PLHIV, as well as methods of its treatment, correction and rehabilitation remain unresolved health issues.
Purpose: to investigate the link between fatigue in people living with HIV (PLHIV), their domestic physical activity and the factors that can affect it.
Materials and methods: 60 patients of PLHIV, 40 men and 20 women aged 23-61, 53 patients with clinical stage IV of HIV infection and 7patients with stage III were examined. The degree of fatigue was studied using the FAS fatigue assessment scale. Physical activity was studied using a physical activity diary, quality of life (YJ) – questionnaire SF 36. The average sleep duration patients determined using portable trackers. CD4+ T-lymphocyte level was determined by running cytoflluorimetry, viral load – using REAL-time PCR.
The results of the study and their analysis. The degree of fatigue in PLHIV ranged from 17 to 47 points, the average value of the indicator - 36.4 ± 6.4 points. The first group included 46 patients with severe fatigue, and the second group - 14 patients with moderate. The level of CD4+ T-lymphocytes in patients of the second group was 487 ± 137.3 kl/ml, in the first group - 116.3 ± 116.6 kl/ml. The viral load level, on the contrary, was higher in the first group – 402243.6 ± 396089.7 kopecks/ml versus 201360.5 ± 198766.7 kopecks/ml in the second group. The body mass index in the first group was 19.2 ± 3.1 and in the second one – 21.3 ± 3.4. Blood pressure fluctuated normally (for the first group 128.7/73.5 mmHg and for the second group 122.3/80.5 mmHg). In the group of patients with severe fatigue it is established: direct correlation with viral load (r = 0.16, p = 0.02), positive correlation between the mental component of YJ and sleep duration (r = 0.24, p = 0.06); feedback on physical household activity (r = -0.43, p = 0.0001), total YJ (r = -0.16, p = 0.02), physical and mental components of THE YJ – r = -0.19, p = 0.03 and r = -0.37, p = 0.13 respectively, CD4+ T-lymphocytes and viral load (r = -0.25, p = 0.06). In the patient group, moderate fatigue is established: direct correlation between fatigue and sleep duration r = 0.46, p = 0.22, viral load r = 0.24, p = 0.28; the reverse correlation was between the degree of fatigue and the overall rate of YAJ r = -0.18, p = 0.03, physical component YAZH r = -0.15, p = 0.02., CD4+ T-lymphocytes level r = -0.27, p = 0.17, physical household activity r = -0.35, p = 0.005, viral load r = 0.53, p = 0.28.
Conclusion It is established that household physical activity can reduce fatigue in PLHIV. Sleep duration has a positive effect on the health patterns we have studied in PLHIV. Our study also demonstrated that fatigue is associated with high levels of viral load, low quality of life, and body mass index especially among those PLHIV who experience moderate fatigue. Fatigue in PLHIV remains an unresolved, urgent clinical problem that requires urgent and maximum effective solution, in particular, methods and means of physical therapy. There is a need to develop a mathematical model for assessing fatigue, testing to choose adequate therapeutic interventions.
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