Important note: Information in this article was accurate in 2005. The state of the art may have changed since the publication date.Can you please tell me if black lines/bands in both finger nails and toe nails are a sign and/or symptom of the HIV virus, as I work with HIV positive people on a daily basis and have noted that nearly all our patients have this commmonly.
Rodger MacArthur, M.D.
Wayne State University
Division of Infectious Diseases
The dark discolorations noted in fingernails and toenails are a result of therapy with zidovudine. The mechanism by which zidovudine causes these changes is uncertain. While harmless, the discolorations often are quite disconcerting to patients, and often are noticed by patients' friends and family. The discolorations resolve within several months after zidovudine is discontinued. Other changes in fingernails and toenails in HIV-infected persons include: thickened and cracked nails caused by fungus (onychomycosis); and ingrown toenails, caused by the antiretroviral indinavir.
HIV itself does not cause any of these changes, although skin color (most noticeable on the face) can darken markedly late in the course of HIV infection in persons not on antiretroviral therapy. HIV appears to be able to stimulate the release of melanin, the pigment responsible for skin darkening, especially at high viral loads. These changes are not harmful, but are quite obvious to the patient and his/her friends and family. Suppressing HIV RNA with antiretroviral therapy usually is effective in reversing the skin darkening within 6 months to 1 year.
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