aids therapies:indinavir-ritonavir treatment may cause ingrown toenails

AIDS Weekly Plus AIDS Therapies: Indinavir-Ritonavir Treatment May Cause Ingrown Toenails Michael Greer, Staff Medical Writer
September 17, 2001

- Researchers in Delaware warn that severe cases of ingrown toenails have been observed in HIV patients treated with indinavir (IDV) and ritonavir (RTV). Dr. Christopher W. James and colleagues working with Christiana Care Health Services' Community HIV Program described their experience with this side effect in the Annals of Pharmacotherapy. Ingrown nails and the accompanying inflammation are exacerbated in patients infected with HIV and often require surgery for resolution, they said. The researchers described five cases of ingrown toenails with paronychia, or inflammation of tissue around the nail. Although all patients required surgery to deal with this condition, which often involved multiple digits and became recurrent in two patients, they found that most decided to continue therapy in order to maintain successful viral control. The development of ingrown toenails was a known effect of other regimens containing indinavir, which heightens retinoic acid signaling, according to James and coauthors. However, the risk may be higher in patients combining the drug with ritonavir, which boosts indinavir levels and prolongs its effects. The median time to ingrown toenail development in the patients studied was 18.4 weeks after therapy initiation ("Recurrent ingrown toenails secondary to indinavir/ritonavir combination therapy," Ann Pharmacother 2001 Jul;35(7-8):881-884. "With the increasing popularity of IDV/RTV combination therapy, clinicians should be aware of the potential increase in frequency of dose-related toxicities including IGTN [ingrown toenails]," James and colleagues concluded. "Evaluation of hands and feet on physical examination should be recommended for all patients being treated with lamivudine and IDV, especially when used in combination with RTV." The corresponding author for this report is Christopher W. James, Doctor of Pharmacy, Christiana Care Health Services, HIV Community Program, 501 W. 14th St., Wilmington, DE 19801, USA. A search at www.NewsRx.net using the search term "AIDS and HIV therapy" yielded 1,191 articles in six specialized reports. Key points reported in this study include: Severe cases of ingrown toenails have been seen in HIV patients taking indinavir with ritonavir Affected patients are likely to develop this condition in multiple digits and often require surgical resolution While this side effect has been reported in patients treated with other indinavir based regimens, ritonavir enhancement of indinavir levels may increase risk This article was prepared by AIDS Weekly editors from staff and other reports.

Most Read: Latest Added Related Topics White House LGBT Conference on HIV/AIDS UNITED STATES: White House in Atlanta: LGBT AIDS Conference No more single-theme conferences: global HIV prevention conference planned FHI 360 Senior Scientist Lut Van Damme Receives International Microbicide Conference Lifetime Achievement Award Equatorial Guinea Ministry of Health and Social Welfare and UNICEF Refute Erroneous AIDS Prevalence Figures Photographs from A Day with HIV Now Online Bulgaria urges Libya to investigate AIDS nurses case Engineers enter fight against AIDS in Africa Gilead’s Complera® Non-Inferior to Atripla® Among Treatment-Naive HIV Patients UN chief Ban calls world leaders to end Aids by 2020 Positive living Lawyer: NY man at center of HIV scare not positive Zimbabwe activist: Prisoners denied AIDS drugs Youth organizations form a pact for social transformation in the AIDS response CountyCare Offers Historic Opportunity to Improve Care for People with HIV International AIDS Advocates Demand China Give $1 Billion to Global Fund Kingdom of Bahrain and UNAIDS commit to intensify cooperation CANADA: Celibate Homosexual Men Now Allowed to Donate Blood in Canada AFRICA: UN: AIDS Deaths Down, Treatment Up in Africa MICHIGAN: STD Fee for Jackson County Walk-In Clinic Takes Effect June 3 UN: AIDS Deaths Down, Treatment Up in Africa Nairobi Solidarity Rally May 10 Proclaims: “No Retreat on AIDS – Treatment for All”AHF: Global AIDS Patients, Doctors Lobby Congress on PEPFAR Reauth International AIDS Advocates Demand China Give $1 Billion to Global Fund Zimbabwe activist: Prisoners denied AIDS drugs Youth organizations form a pact for social transformation in the AIDS response AFRICA: UN: AIDS Deaths Down, Treatment Up in Africa NEW YORK: Catskill Hospital Warns That Insulin Pens May Have Been Reused DELAWARE: Cape Henlopen Theatre Academy to Host 'Magic to Do' May 25 GLOBAL: HIV Outcomes Could Improve by Integrating Treatment of Comorbid Mental Illness
Copyright © 2001 -AIDS Weekly Plus, Publisher. All rights reserved to Charles Henderson, Publisher. Permission to reproduce granted to AEGIS by Charles W. Henderson. Authorization to reproduce for personal use granted granted by C. W. Henderson, Publisher, provided that the fee of US$4.50 per copy, per page is paid directly to the Copyright Clearance Center, 27 Congress Street, Salem, Massachusetts 01970, USA. Published by Charles Henderson, Publisher. Editorial & Publishing Office: P.O. Box 5528, Atlanta, GA 30307-0528 / Telephone: (800) 633- 4931; Subscription Office: P.O. Box 830409, Birmingham, AL 35283-0409 / FAX:(205) 995-1588 Visit AIDS WEEKLY PLUS. Information in this article was accurate in September 17, 2001. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.