Doravirine/tenofovir disoproxyl fumarate/lamivudine-induced alopecia: A case report

Int J STD AIDS. 2022 Jun;33(7):726-727. doi: 10.1177/09564624221096299. Epub 2022 May 1.

Abstract

We report here a case of alopecia probably caused by the fixed dose combination of doravirine/tenofovir disproxil fumarate/lamivudine (DOR/TDF/3TC) in a 46-year-old male living with HIV, previously treated with tenofovir disproxil fumarate and lamivudine-containing antiretroviral combinations. After having excluded other causes of hair loss such as sexually transmitted disease or drugs associated with alopecia, as well as poor immune-virologic conditions (i.e. low CD4+ cell count and/or high HIV viral load), a toxic effect of doravirine might be hypothesized. DOR/TDF/3TC was immediately stopped and rilpivirine plus tenofovir alafenamide fumarate/emtricitabine was started. Four weeks after changing the antiretroviral regimen, the patient reported signs of hypopigmented hair regrowth. The association between the episode of alopecia and DOR/TDF/3TC was scored as probable according to the Naranjo causality scale. We concluded that alopecia was probably related to DOR but whether it is self-limiting, cannot be predicted at this stage.

Keywords: AIDS < viral disease; ART (antiretroviral therapy) < other; toxicity < other.

Publication types

  • Case Reports

MeSH terms

  • Alopecia / chemically induced
  • Alopecia / drug therapy
  • Anti-HIV Agents* / adverse effects
  • Anti-Retroviral Agents / therapeutic use
  • Emtricitabine / therapeutic use
  • Fumarates / adverse effects
  • HIV Infections* / drug therapy
  • Humans
  • Lamivudine / adverse effects
  • Male
  • Middle Aged
  • Pyridones
  • Tenofovir / adverse effects
  • Triazoles
  • Viral Load

Substances

  • Anti-HIV Agents
  • Anti-Retroviral Agents
  • Fumarates
  • Pyridones
  • Triazoles
  • Lamivudine
  • doravirine
  • Tenofovir
  • Emtricitabine