Nail changes in patients infected with human immunodeficiency virus. A prospective controlled study

Area of Science:

• Dermatology
• Infectious Diseases
• Immunology

Background:

• Nail changes are observed in various systemic diseases.
• The prevalence and specific types of nail alterations in human immunodeficiency virus (HIV)-infected individuals require further investigation.

Purpose of the Study:

• To determine the frequency of nail abnormalities in HIV-positive patients.
• To compare the occurrence of these nail changes with HIV-negative controls.
• To explore potential links between nail symptoms and the level of immunosuppression.

Main Methods:

• A prospective controlled study was conducted.
• Nail changes were assessed via standardized clinical examination in 155 HIV-1-positive patients and 103 HIV-negative controls.
• Mycological cultures were performed for suspected onychomycosis.

Main Results:

• Nail symptoms were present in 67.7% of HIV-positive patients versus 34.0% of controls (P << .001).
• Significantly higher frequencies of clubbing, transverse lines, onychoschizia, leukonychia, and longitudinal melanonychia were noted in the HIV group.
• Onychomycosis was more prevalent in HIV patients (30.3%) compared to controls (12.6%) (P < .001), with *Trichophyton rubrum* being common. Onychomycosis frequency increased with advanced HIV disease stages.

Conclusions:

• Nail symptoms are substantially more frequent in HIV-infected individuals than in healthy controls.
• Certain nail changes may serve as indicators related to the degree of immunosuppression in HIV patients.