Original Paper

Self-Reported Fatigue Common among Optimally Treated HIV Patients: No Correlation with Cerebral FDG-PET Scanning Abnormalities
Åse B. Andersen^a, Ian Law^b, Sisse R. Ostrowski^a, Anne Mette Lebech^a, Gunilla Høyer-Hansen^c, Liselotte Højgaard^b, Jan Gerstoft^a, Henrik Ullum^d, Andreas Kjær<sup>b

a</sup>Department of Infectious Diseases,
^bDepartment of Clinical Physiology, Nuclear Medicine and PET,
^cThe Finsen Laboratory, and
^dDepartment of Clinical Immunology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

Address of Corresponding Author

Neuroimmunomodulation 2006;13:69-75 (DOI: 10.1159/000095222)

  Key Words

• Anti-retroviral treatment
• Fatigue
• Cytokine profile
• Interleukin 6
• Tumour necrosis factor-
• Soluble urokinase receptor
• Fluorine-18-fluorodeoxyglucose positron emission tomography brain scanning

  Abstract

Objective: It was the aim of this study to determine the prevalence and severity of fatigue among optimally treated HIV patients and to investigate the potential association with systemic inflammation and abnormalities of the distribution of cerebral glucose metabolism. Methods: A cohort of HIV patients (n = 95), known to be HIV positive for 5 years, on anti-retroviral therapy for a minimum of 3 years and with CD4 counts above 0.2 × 10⁹ cells/l, completed a validated fatigue inventory, and plasma was analysed for pro-inflammatory markers including tumour necrosis factor-, interleukin 6 and soluble urokinase receptor (suPAR) levels. The distribution of the regional cerebral metabolic rate of glucose was measured in a sub-group of patients suffering from severe fatigue (n = 9) and a group with no fatigue (n = 7) using fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) scanning. Results: Fifteen percent suffered from severe fatigue, but no association with pro-inflammatory markers was found. About 50% of the FDG-PET-scanned patients showed minor abnormalities in the relative cerebral metabolic rate of glucose. These abnormalities were not associated with fatigue but tended to correlate with a short HIV history (p = 0.058), a low CD4 nadir (p = 0.082) and elevated tumour necrosis factor- levels (p = 0.074). Conclusion: Fatigue is common among optimally treated HIV patients. FDG-PET-described signs of imminent neurodegeneration among HIV patients who had a low CD4 nadir may illustrate an aspect of HIV neuropathogenicity.

Copyright © 2006 S. Karger AG, Basel

  Author Contacts

Åse Bengård Andersen, MD, DSc
Department of Infectious Diseases M5132
Rigshospitalet, Blegdamsvej 9
DK-2100 Copenhagen OE (Denmark)
Tel. +45 3545 8555, Fax +45 3545 6648, E-Mail bengaard@rh.dk

  Article Information

Received: February 22, 2006
Accepted: July 3, 2006
Published online: August 22, 2006
Number of Print Pages : 7
Number of Figures : 3, Number of Tables : 4, Number of References : 34