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Treatment of Fungal Nail Infection
Nov 30, 2011


I read your response ( on Fungal Nail Infections and was wondering if you could offer me some advice.

I've been on Atripla for just over 2 yrs and my CD4s are stable 300 ish and VL undetectable; I have been taking Lamisil once a day for 9 months to treat a Fungal nail infection. The infection has improved but seems to have 'stagnated' the nail is now again firm but still mostly discoloured (though this has changed from yellow to white).

Should I continue on with the treatment 'indefinitely' or look at trying something else? I know they are difficult to clear and HIV probably accentuates this but I would really like to do all I can to clear the infection.

Thanks in advance for your advice.

Response from Dr. Henry

You may want to make sure you have a fungal infection by getting nail samples sent to lab or seeing specialist (typically dermatologist or podiatrist). If diagnosis of fungal infection seems valid then in some cases response is slow /poor even to typically effective treatment (sometimes I might switch to alternative regimen such as weekly oral fluconazole) with very long term tretment (ie 6-12 months) sometimes needed. Some cases simply dont clear very well despit all efforts. KH

alpha lipoic acid, interaction with Efavirenz + Truvada
sores with hiv

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