Payne, B A I, Hateley, C L, Ong, E L C et al. · HIV medicine · 2013 · DOI
This study looked at fatigue in people living with HIV who were taking modern HIV medications and had their virus under control. Surprisingly, about half of these patients still reported significant fatigue, even though their HIV was suppressed and their immune systems were recovering. The researchers found that fatigue was often linked to problems with blood pressure control (orthostatic intolerance) and previous exposure to certain older HIV medications.
This research identifies dysautonomia (autonomic nervous system dysfunction) as a potential shared biological mechanism between HIV-associated fatigue and ME/CFS, opening possibilities for common therapeutic approaches. Understanding that fatigue persists despite successful viral suppression shifts focus from viral replication to metabolic and physiological dysfunction—insights directly relevant to ME/CFS pathogenesis and treatment strategies.
This cross-sectional study cannot establish causation; the correlation between orthostatic intolerance and fatigue does not prove dysautonomia causes fatigue. The study does not directly compare treatment approaches or test interventions targeting dysautonomia. Findings in HIV patients, while suggestive, may not directly translate to ME/CFS populations due to different underlying disease mechanisms.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Payne, B A I, Hateley, C L, Ong, E L C, Premchand, N, Schmid, M L, Schwab, U, et al. (2013). HIV-associated fatigue in the era of highly active antiretroviral therapy: novel biological mechanisms?. HIV medicine. https://doi.org/10.1111/j.1468-1293.2012.01050.x
BibTeX
@article{mecfsatlas-payne-2013-hiv-associated,
author = {Payne, B A I and Hateley, C L and Ong, E L C and Premchand, N and Schmid, M L and Schwab, U and Newton, J L and Price, D A},
title = {HIV-associated fatigue in the era of highly active antiretroviral therapy: novel biological mechanisms?},
journal = {HIV medicine},
year = {2013},
doi = {10.1111/j.1468-1293.2012.01050.x},
note = {PubMed: 22998022},
url = {https://www.mecfsatlas.com/evidence/payne-2013-hiv-associated},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/payne-2013-hiv-associated
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