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There are also acute and chronic types of fatigue. Acute fatigue is generally short-lived, sudden in onset, and relieved by rest. Chronic fatigue lasts a long time (usually six months or longer), may be insidious in onset, and is usually not relieved by rest.

How common is fatigue?
Among people living with HIV and AIDS, the prevalence of fatigue is quite high. In two studies, 54 and 67 percent of people reported fatigue as a symptom at some point during their course of disease. People with HIV are more likely to suffer from fatigue that interferes with their daily activities than people not infected with the virus. One team of researchers found that when compared with persons not infected with HIV, those with HIV were more likely to be unemployed, to feel fatigued for more hours of the day, to sleep and nap more, and to have a lower level of morning alertness.

Even among people living with HIV, the prevalence of fatigue differs: those with more advanced disease (lower CD4 cell count and/or history of opportunistic infections) are more likely to experience fatigue.

What causes fatigue?
There are numerous possible causes of fatigue among persons with HIV infection. Often, a person with fatigue has several problems that can interact to cause this symptom. Here are possible causes of fatigue:

Laws and Penalties:  Concerns over growing illegal AAS abuse by teenagers, and many of the just discussed long-term effects, led Congress in 1991 to place the whole AAS class of drugs into Schedule III of the Controlled Substances Act (CSA).  Under this legislation, AAS are defined as any drug or hormonal substance, chemically and pharmacologically related to T (other than estrogens, progestins, and corticosteroids) that promotes muscle growth.  The possession or sale of AAS without a valid prescription is illegal.  Since 1991, simple possession of illegally obtained AAS carry a maximum penalty of one year in prison and a minimum $1,000 fine if this is an individual’s first drug offense.  The maximum penalty for trafficking (selling or possessing enough to be suspected of selling) is five years in prison and a fine of $250,000 if this is the individual’s first felony drug offense.  If this is the second felony drug offense, the maximum period of imprisonment and the maximum fine both double.  While the above listed penalties are for federal offenses, individual states have also implemented fines and penalties for illegal use of AAS.  State executive offices have also recognized the seriousness of AAS abuse and other drugs of abuse in schools. For example, the State of Virginia enacted a law that will allow student drug testing as a legitimate school drug prevention program (48, 49).

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