Clinical sequelae affecting quality of life in the HIV-infected patient.

Physical and mental changes resulting from HIV infection and its treatment can affect a patient's quality of life (QOL). Some of the most commonly reported symptoms affecting QOL in HIV-infected patients are fatigue, pain, anxiety/depression, and sleep disturbances. Fatigue often has a multifactorial etiology, including advanced HIV disease, opportunistic infections, poor nutrition, hormonal insufficiency, and anemia. Pain is one of the most overlooked factors by clinicians. Anxiety/depression and sleep disturbances are experienced by many HIV-infected individuals and are highly correlated with the perception and progression of disease. Although these common clinical symptoms impact QOL in HIV-positive patients, there are no established guidelines for treating them. As pain, anxiety/depression, and sleep disturbances can influence fatigue, as well as each other, the HIV care provider should monitor them closely because their severity reflects the clinical course of HIV as well as the overall well-being of the patient.