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Various hair changes have been reported in human immunodeficiency virus (HIV)–infected patients.1 - 4 The prevalence of these changes, however, has not been studied.
The Women's Interagency HIV Study (WIHS) is a multicenter prospective study of women in the United States who have HIV or are at risk for HIV disease.5 During the evaluation period of April 2000 through September 2000 a hair questionnaire was administered to 336 HIV-infected and 91 non–HIV-infected (HIV-noninfected) women in the Northern California WIHS.
The questionnaire focused on personal and family history of hair loss, current assessment of hair density, change in hair characteristics, eyebrow and eyelash length, and hair grooming practices. Information on demographics, medication use, and laboratory values was also assessed. Women infected with HIV who were taking a combination of antiretroviral medications that included a protease inhibitor or nonnucleoside reverse transcriptase inhibitor were labeled as being on highly active antiretroviral therapy (HAART).
For bivariate analyses, χ2 and Fisher exact tests were used. Multivariate logistic regression analysis was performed to evaluate possible risk factors for the outcome of abnormal skin examination findings.
A total of 196 HIV-infected and 50 HIV-noninfected women completed the questionnaire. Demographics of the groups were not significantly different (Table 1). One hundred eight (55%) of the HIV-infected women reported HAART use.
There were no significant differences in family history of hair loss, in eyebrow length, or in hair grooming practices between the 2 groups. Older age (but not HIV status) was associated with a report of decreased hair density (odds ratio, 1.5; 95% confidence interval, 1.1-2.2).
Participant reports of changes in hair characteristics are shown in Table 2. The HIV-infected women were more likely to report finer hair (28%) compared with the HIV-noninfected women (12%) (P<.01). In the multivariate logistic regression analysis, HIV infection was an independent predictor of finer hair (odds ratio, 2.8; 95% confidence interval, 1.06-7.5). The HIV-infected women with finer hair had significantly higher viral load counts (P<.01) and showed a trend toward lower CD4 cell counts. Medication use (HAART) in the HIV-infected women was not associated with finer hair.
Five HIV-infected women reported having longer eyelashes, whereas no HIV-noninfected women reported this change. All of their CD4 cell counts were less than 250/µL. Only 3 of these participants were taking HAART.
In the Northern California WIHS, the prevalence of finer hair was more common among HIV-infected women than among the comparison group of HIV-noninfected women (28% vs 12%; P<.01). Higher viral loads in the HIV-infected women were significantly associated with finer hair, supporting the possibility that more advanced HIV infection is associated with this hair characteristic.
Chronic, diffuse hair loss in HIV-infected patients has been reported and attributed to either chronic illness2 or use of antiretroviral medications.1 In our cohort, decreased hair density was not associated with HIV infection or HAART use. We were unable to assess any association between specific antiretroviral drugs and hair density due to smaller sample sizes.
Longer eyelashes were reported exclusively by 5 HIV-infected women in our cohort. Previous reports have suggested longer eyelashes (trichomegaly) to be a marker for late-stage HIV disease.3 - 4 In our cohort, all patients with longer eyelashes had a CD4 cell count less than 250/µL, supporting the possibility that this finding may be associated with progressive disease.
In summary, it is important to recognize that diffuse hair loss or decreased hair density may be due to causes other than HIV infection; however, longer eyelashes and finer hair may be markers for the disease.
The Northern California WIHS is funded by grants U01-AI-34989, MO1-RR-00079, and MO1-RR-00083 from the National Institutes of Health, Bethesda, Md.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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