The Body Covers: The XIII International AIDS Conference
Bones and Nails
July 13, 2000
This report compared the antiretroviral therapies used by 28 persons with HIV and ingrown toe nails to the therapies used by persons with HIV without ingrown toe nails. Both groups had been diagnosed for a similar amount of time, but information about other characteristics, such as viral load and CD4 cells was not given. Use of antiretroviral therapy and use of indinavir (IDV) were significantly associated with ingrown toe nails. Almost as many patients were on stavudine (d4T) and lamivudine (3TC) as were on IDV, but there was not an association with these drugs after accounting for use of protease inhibitors (the drug class that IDV belongs to).
The authors suggest that the link between IDV and ingrown toe nails is unique and not seen with other protease inhibitors. My sense is that ingrown toe nails do occur in persons with HIV on antiretroviral therapy and that additional studies to confirm these data would be useful to aid in management of this condition. Since most patients take a combination of antiretroviral drugs, it may be difficult in a small study to be certain about the association with one specific drug. From a practical viewpoint, until more data are available, if a patient receiving IDV develops recurrent ingrown toe nails, substituting another antiretroviral for IDV would be a reasonable approach.
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