Fatigue, HIV Reservoirs, and Why Rest is Important

Today I did not go to work.  I had night sweats all night with a fever, so I stayed home.  I slept all day, only getting up to eat some Fruity Pebbles or go to the bathroom.

HIV is a chronic, long-term infection.  It is a presence in the body to which the immune system mounts a constant, persistent battle against, 24 hours a day, 7 days a week.  Even though I am on HIV medication, there still exists reservoirs of the virus inside my body, in places where the medicine does not reach: the brain, the lymphatic system, organs, tissues.

You see, HIV medications only impact the virus floating around in your blood stream.  The molecular size of the medicine is too large to reach anywhere else; it simply can not physically reach most places in the body...think of trying to fit a boulder through the holes of a chain-link fence.  It simply can not fit through it.

Anyway.  So, for me I have always battled fatigue.  It is a part of my diagnosis that has never went away.  Oh, I hide it well, and ignore it and push through it most of the time.  But, it is always there.  And sometimes, like today, it gets the best of me.  Days like today I can not even manage to get out of bed, literally.  I woke up at one point today, sweating with a fever, and wanted to get up and turn on my box fan, and yet I just didn't have the energy to get up and do it.

Other than the HIV itself, there is no known infectious cause of my fatigue.  I have had every test imaginable to find out why I remain exhausted.  Most likely it is due to the HIV itself, always active in the background periphery of my biology.  My body uses up so much energy fighting my latent HIV infection, latent as in 'that which HIV meds doesn't touch'.  It is such a huge myth that people believe that if you just take a pill you will be fine, you will be just like those without HIV.  I wish that was true, but it is not.

Even when one is consistent in their treatment there still exists HIV in sufficient quantities in the body to trigger the immune response.  When the body's immune response is turned on 24/7 the body is then in a persistent state of systemic inflammation.  Inflammation is an immune response to infection, whereas the body becomes revved up, ready to fight.  Inflammation is like the fight or flight response of the immune system.  It is great when it works as needed, and not so great when it is turned on all the time.

Think what damage one could do to a car if they drove it across the country without once turning off the engine, filling it with gas to continue to go further and further and further.  Eventually gaskets will fail, seals will crack, things will fall apart.  That is what systemic inflammation does to the body.  And that is what I feel at times.  So when that happens all I can do is listen to my body, rest, sleep, take care of myself.


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