'AIDS Battle Fatigue'

Survey finds HIV patients have trouble sticking to tough drug regimen

By Robert Preidt
HealthScout Reporter

http://healingwell.subportal.com/

SATURDAY, March 31 (HealthScout) -- A new survey says many people with HIV suffer from "AIDS battle fatigue," which is caused by the demands of having to swallow handfuls of pills every day, side effects caused by the drugs and food restrictions.

The finding is a concern because these people need to stick to their drug treatments to fight the virus and prevent mutations, which can lead to drug resistance and treatment failure.

"We can't make enough noise about this because it's the most important issue in HIV care," says Dr. Charles Farthing, medical director of the AIDS Healthcare Foundation in Los Angeles.

The survey, done by questionnaire and the Internet, includes the responses of 292 HIV-positive patients taking medication. Of those, 62 percent said it's somewhat or very difficult to adhere to their drug regimen.

The survey found the major obstacles to complying with treatment include having to take too many pills (67 percent), side effects (61 percent), food restrictions (55 percent), the frequency of having to take the pills (49 percent) and the timetable for taking the pills (48 percent). Only 1 percent said cost was a problem.

The survey also found 43 percent of those respondents said the drug regimen interfered with their daily life, 30 percent said it interfered with their lifestyle, and 11 percent said it interfered with their job.

The survey was conducted in September by Savitz Research and funded by GlaxoSmithKline.

David Morris is well aware of the fatigue factor.

He was diagnosed with HIV in 1983, and takes 14 pills each day. Morris, who coined the "AIDS battle fatigue" term, is administrator of the wellness program at Beth Israel Deaconess Medical Center in Boston and counsels HIV patients.

As well as having to keep a rigorous pill schedule, he has to be constantly aware of drug-related food restrictions and other issues. All this serves as a constant reminder that you're sick, Morris says.

This "battle fatigue" is something that people without HIV may not be able to understand, Morris says. But he notes many people complain about having to take an antibiotic for 10 days.

"But this is something that goes on for the rest of your life, and is probably going to change and increase as you get older," Morris says.

There's no such thing as a vacation from the regimen. Even if he's going away for just a day, Morris has to plan ahead and make sure he has his proper medication with him. Morris says he copes with the drug demands in different ways, but it comes down to a simple understanding.

"You have two choices: to do it with a positive attitude or to just curl up and die," Morris says. "Even though it's not the most optimal solution, it is probably the only one right now and tomorrow's going to be a better day."

These survey results don't surprise anyone on the medical frontlines of HIV care, Farthing says.

"It took awhile to realize that non-adherence was a huge problem, and then to think and look for all the reasons behind it," Farthing says.

"There's no doubt that if people do not take antiretroviral therapies regularly, the disease will progress and death will occur from AIDS," Farthing says.

"We do not have a cure for this disease," he says. "The only way we can keep people alive and well is to keep them on continuous therapy."

He says there are ways to counter this sense of fatigue. Doctors need to spend more time talking and doing follow-up to make sure their patients are sticking to their drug regimen. For example, doctors need to see their HIV patients every one or two months instead of every three to four months.

Another approach is development of new drugs that will give HIV patients the same benefits with fewer pills.