Generalized hair loss as an adverse effect of antiretroviral therapy in an HIV-1 positive man – a case report

Abstract

Summary Hair loss can be one of adverse effects of antiretroviral therapy among HIV infected patients. There are only few reports in literature concerning alopecia in patients treated with protease inhibitors. Most of them are related to indinavir use and only few to other drugs. A 40-year-old HIV-1 infected man developed complete hair loss after 3 months of effective antiretroviral therapy with lopinavir/ritonavir plus saquinavir. Hair loss was diffuse, progressive and complete affecting scalp, eyelids, eyebrows, beard, axillar and pubic areas, arms, legs and body hair. After 4 weeks of new treatment, the new regimen being nevirapine, emtricitabine and tenofovir, thin and sparse moustache hair began to appear. No further signs of hair re-growth have been seen. To our knowledge, there are 3 reports of lopinavir/ritonavir-related hair loss in the literature, our being only the fourth one – if the described alopecia was actually caused by lopinavir/ritonavir use. On the other hand, there have been no reports concerning alopecia after saquinavir use. We cannot establish whether generalized hair loss in our patient was due to lopinavir or saquinavir alone or both drugs used simultaneously. Although generalized hair loss after PIs use is rare, clinicians should be aware of this side effect, especially because of its possible negative influence on the quality of life.