EVALUATION OF THE EFFECTIVENESS OF THE TREATMENT OF ONYCHOMYCOSIS OF THE FOOT IN HIV-INFECTED PEOPLE ON THE BACKGROUND OF ANTIRETROVIRAL THERAPY
DOI:
https://doi.org/10.11603/1681-2727.2026.1.16160Keywords:
HIV infection, mycoses of the skin and its applications, antiretroviral therapyAbstract
The aim of this study was to evaluate the effectiveness of treatment of onychomycosis of the feet in HIV-infected patients depending on the effectiveness of antiretroviral therapy (ART).
Patients and methods. 96 HIV-infected patients with onychomycosis of the feet were under observation.
The diagnosis of HIV infection was established according to the International Classification of Diseases of the 10th revision (ICD-10) and verified by the detection of specific serological and molecular biological markers of HIV. The number of CD4+-lymphocytes and viral load (copies/ml) were recorded in all patients.
Considering the effectiveness of ART, HIV-infected patients with onychomycosis of the feet were divided into four groups. Group I included patients with virological and immunological ART success; to the II group – patients with a decrease in viral load without an increase in the number of CD4+-lymphocytes or with an increase in the level of CD4+>500 cells/μl without a decrease in viral load; to the III group – patients with an immunological response, but without a decrease in the viral load; to IV group – persons with virological and immunological failures of ART. Thus, 30 people were under observation in the 1st group; in the II group – 20; in the III group – 11; in the IV group – 35 patients.
From the systemic antifungal therapy, HIV-infected patients of the I group received terbinafine 250 mg per day for 12 weeks. Patients of the II group received itraconazole 200 mg 2 times a day according to the scheme of pulse therapy on the 1st, 5th and 9th weeks of treatment. In groups III-IV, patients were prescribed fluconazole at a dose of 150 mg once a week for 6 months.
The results. On the 6th month of observation, the effectiveness of antifungal therapy for onychomycosis of the feet in patients with virological and immunological successes of antiretroviral therapy was significantly higher than in patients with virological and immunological failures of antiretroviral therapy (p<0.01).
At the 12th month of observation, the mycological, clinical and full effectiveness of antifungal therapy for onychomycosis of the feet was statistically significantly higher in the case of virological and immunological success of antiretroviral treatment, compared to the group of patients in whom such a result of etiotropic therapy of HIV infection could not be achieved (р<0.01).
Conclusions. Evaluation of the effectiveness of antifungal therapy for onychomycosis of the feet in HIV-infected patients in groups formed depending on the effectiveness of antiretroviral treatment showed the best results in the group with a successful option of using antiretroviral drugs and the worst in the group with a negative result of such treatment. In representatives of the group with a lack of positive dynamics of one of the indicators (viral load or the number of CD4+-lymphocytes), the combined therapy of onychomycosis of the feet showed intermediate results.
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Copyright (c) 2026 V. D. Moskaliuk, I. I. Kravchuk, Yu. O. Randiuk, I. V. Вalaniuk
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Accepted 2026-04-18
Published 2026-04-20
