title: Alopecia induced by lopinavir plus ritonavir therapy in an HIV patient.
abstract: The most commonly reported side effects related to lopinavir/ritonavir are diarrhea, vomiting, headache, nausea, and increased serum triglycerides and cholesterol levels. About 4% of the patients prescribed lopinavir/ritonavir stop taking it because of side effects. Alopecia, generally involving the scalp, has been reported in patients with HIV infection treated with indinavir but not with lopinavir/ritonavir. We present a 62-year-old man with HIV infection, stage B2, who experienced alopecia totalis of his scalp, eyebrows, and eyelashes beginning 18 months after initiating antiretroviral treatment including lopinavir/ritonavir. No hair loss on the arms, legs, and pubic area was observed. Our patient's drug regimen consisted of lopinavir/ritonavir, efavirenz, and stavudine; in addition, the patient was receiving treatment for diabetes with glivenclamide and metformin for the last 3 years. These drugs have not been shown to cause alopecia. Alopecia reversed completely 2 months after substituting nelfinavir for lopinavir/ritonavir without any other change of treatment and his eyelashes and eyebrows grew back as well. To our knowledge, this is the second case of lopinavir/ritonavir-associated alopecia totalis reported in the international literature.
authors.affiliation: Infectious Diseases Unit, Tzanio General Hospital of Piraeus, Piraeus, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Chrysos
authors.forename: Sotirios
authors.initials: S
authors.lastname: Mikros
authors.forename: Stelios
authors.initials: S
authors.lastname: Kokkoris
authors.forename: Androula
authors.initials: A
authors.lastname: Pastelli
authors.forename: George
authors.initials: G
authors.lastname: Kontochristopoulos
mesh_terms: D000505:Alopecia / Q000139:chemically induced* / Q000517:prevention & control; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D015658:HIV Infections / Q000188:drug therapy; D006801:Humans; D061466:Lopinavir; D008297:Male; D008875:Middle Aged; D019888:Nelfinavir / Q000627:therapeutic use; D011744:Pyrimidinones / Q000009:adverse effects* / Q000627:therapeutic use; D019438:Ritonavir / Q000009:adverse effects* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D011744:Pyrimidinones; D061466:Lopinavir; D019888:Nelfinavir; D019438:Ritonavir