dear doctor:i am a woman of 38 hiv for the last 20 years on haart for the last 5 years when i was diagnose with mai nowdays on ziagen,viracept and epivir my cd4 11 and cv 49 copies i also have hep c but low liver enzimes, my hair has always been very curly and thinck but for the last 2 months is almost straight and i have lost almost half of it, what do you think i should be checking for as in spain where i live there is not much information about it. kindest regards

HIV infection can cause changes in hair texture in some patients as well as hair loss. Some of the HIV medications can also impact hair. 3TC is a drug which is often well tolerated and an important part of many regimens. I have had a number of patients where it looked like 3TC clearly contributed to the hair problem. In some cases another drug can be tried (i.e. ddI capsule) but there are cases where no other decent choices are available. A visit to a dermatologist may help if there is some other scalp codition that could be contributing. Many HIV specialist have encountered this and can offer some options to try. ALso checking that your nutrtional and hormonal status (including thyroid)is often useful. KH