What Is the Effect of HIV on Nails?
Nails serve as a mirror to the internal health of an individual, reflecting changes and abnormalities that might otherwise go undiagnosed. Nails of HIV-positive persons can serve as subtle indicators of their immune system's compromised state.
HIV nails (changes in nails due to HIV) have aroused interest in recent years. There is a wide range of mucocutaneous changes or skin diseases related to human immunodeficiency virus (HIV) infection.
Alterations in nails are frequent in individuals with HIV (human immunodeficiency virus). A few changes are caused by HIV directly, while many changes are caused by suppressed immunity due to HIV and HIV medications.
What Do HIV Nails Look Like?
A study found that more than two-thirds of 155 individuals living with HIV experienced some form of nail change or symptom. If you are living with HIV, you may notice several significant HIV nail symptoms.
5 ways HIV can affect nails:
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Clubbing.
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Melanonychia.
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Onychomycosis.
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Anolunula.
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Terry’s nails.
1. Clubbing:
Clubbing means the fingernails or toenails become more curved and rounded, giving them a bulb-like shape. In people with HIV, clubbing usually develops slowly and is more noticeable in the later stages of the disease. There is no specific treatment for clubbing itself; it usually improves when the underlying cause (such as low oxygen or infection) is treated.
Symptoms of digital clubbing:
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Enlargement of the fingertips.
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Nail discoloration.
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Nail thickening.
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Extremely curved nails.
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Softened nail bed.
2. Melanonychia:
Melanonychia means having dark lines that run from the bottom to the tip of the nail. These lines are usually brown or black and can appear on one or more nails. It can also make the nails look or feel a little different than usual.
This condition can happen in people with HIV or AIDS, especially in those taking a medicine called Zidovudine. But it can also happen in people who are not on any HIV medicines. It does not hurt, but it can make the nails look a bit unusual.
3. Onychomycosis:
When the immune system weakens due to HIV, opportunistic fungi can take advantage. It will lead to conditions such as onychomycosis. It is a fungal disease that affects the nails.
The nails may become discolored, thickened, and brittle, providing a visual cue of the underlying health issues.
Onychomycosis is one of the early manifestations of HIV infection, with a prevalence of approximately 10 to 44 percent. Non-dermatophyte molds are responsible for 2 to 12 percent of onychomycosis. The frequency is four times higher in patients with HIV.
The incidence of onychomycosis has reduced in patients with HIV or AIDS (autoimmune disorder) following the use of combined antiretroviral therapy (cART) and antifungal agents when indicated. However, this disease contributes to a significant source of morbidity. This condition is one of the early-stage HIV nail changes.
4. Anolunula:
The lunula is a half-moon-shaped white area near the base of the nail. The absence of the lunula is called anolunula. It occurs in individuals with HIV when the immune system is weakened.
Anolunula often indicates the presence of malnutrition, anemia, kidney disease, or heart disease. Due to HIV infection, inflammation damages the small blood vessels in the nail bed, leading to anolunula. There is no specific treatment for anolunula.
5. Terry’s nails:
Terry’s nails, or leukonychia, refer to the presence of white discoloration or white spots on the nails. The causes include trauma, fungal infections, nutritional deficiencies, and systemic diseases. It could be an indication of aging.
Terry’s nails could also be due to blood vessel changes in the nailbed. While leukonychia itself is not specific to HIV, it can be observed in individuals living with the virus, often as a result of associated factors. Terry’s nails do not have any specific treatment. Treating the underlying condition would help improve the symptoms of the condition.
Symptoms of Terry’s nails:
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Absence of lunula.
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Nail plates with vertical ridges.
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Brown lines at the nail tip.
What Causes Nail Changes in HIV?
Fungal infections, including Candida and Dermatophytes, are the most common cause of nail changes. Weakening of the immune system causes these infections. HIV compromises the immune system by reducing CD4 T lymphocytes, resulting in fungal infections. Certain medications also cause nail alterations. In most cases, the exact cause of nail changes is unknown.
Why Are Nail Changes Important?
Nails, though generally overlooked, can give valuable insights into an individual's overall health, including the presence and progression of HIV. HIV triggers numerous alterations in the human body, which are exposed through minor signs, apart from weakening the immune system.
Nail changes are significant in HIV because they provide vital information required for treatment. Certain nail changes assist physicians in identifying the stage of HIV infection. Certain antiretroviral drugs can cause certain nail changes as adverse effects.
In some cases, people may worry about getting HIV from nails, but it is important to note that HIV cannot be transmitted through nail contact, unless contaminated blood directly enters an open wound (a situation that is extremely rare).
Conclusion
HIV infection causes numerous nail changes, including clubbing, melanonychia, Terry’s nails, anolunula, and onychomycosis. Some of these changes require treatment, while others may not. Nail changes in HIV get cured when the underlying condition is treated. HIV-related nail changes can affect anyone, and if you notice these changes, get it diagnosed promptly.
Note From iCliniq
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Nail changes can sometimes be an early sign of underlying health issues in people living with HIV.
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Regular checkups and timely treatment can help manage these nail problems effectively. Diagnosing the condition early can help in preventing the disease progression if it is associated with HIV.
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Most nail changes are not dangerous and do not require any specific treatment. Always consult a dermatologist or HIV specialist if you notice unusual changes in your nails.
