Nail changes aren’t a commonly spoken about symptom of HIV. In fact, only a handful of studies have given attention to the nail changes that can occur in people with HIV.

Some nail changes may be caused by HIV medications and aren’t dangerous. But other nail changes can be a sign of a late-stage HIV infection or a fungal infection.

It’s important to be aware of these changes so you can start treatment right away.

Research indicates that nail changes are common in people with HIV.

One older study published in 1998 found that over two-thirds of the 155 people with HIV included in the study had some sort of nail change or symptom compared to those without HIV.

If you have HIV, your nails can change in a few different ways.


Clubbing is when your fingernails or toenails thicken and curve around your fingertips or toes. This process generally takes years and may be the result of low oxygen in the blood.

Clubbing may be an early sign of AIDS in children with HIV.

Thickened nails

The toenails can grow thicker over time and eventually become painful. Thickened nails often occur in the toenails because they’re frequently exposed to wet areas.

For this reason, they’re more susceptible to fungal infections. People with uncontrolled HIV are more prone to fungal infections due to their weakened immune system.

Other symptoms of a fungal infection of the toenails include:

  • yellow, brown, or green color in the toenail
  • a bad odor from the toenail
  • toenails that split or crumble
  • toenails that lift up from the toe bed

Terry’s nails

A condition called Terry’s nails causes the bulk of your nail to appear white. There will just be a small pink or red band of separation near the arc of your nails.

While Terry’s nails is often a normal sign of aging, it may also be more common in people with HIV.

Discoloration (melanonychia)

Melanonychia is a condition that results in brown or black stripes on your nails. Research shows that people with HIV are prone to melanonychia.

The condition is more common in people with a darker skin tone. For people with a dark skin tone, lines on the fingernails can sometimes be normal.

Though melanonychia may be related to the HIV infection itself, it may also be caused by certain medications used to treat HIV.

For example, a previously commonly used anti-HIV drug known as zidovudine, a nucleoside/nucleotide reverse transcriptase inhibitor, can lead to this condition.

Melanonychia isn’t dangerous, however. You should continue to take your medications as advised by your doctor.


Lunula is the white, half-moon shaped area sometimes seen at the base of the fingernail. In people with HIV, the lunula is often missing. Lack of a lunula is referred to as anolunula.

One study looked at 168 HIV-positive people and 168 people without HIV.

Researchers found that more people with HIV were missing the lunula in their fingernails compared with people without HIV.

In this study, the rate of anolunula was found to be higher at the later stages of an HIV infection compared to the earlier stages.

Yellow nails

One common cause of yellow toenails is a fungal infection that attacks the nails. This may be referred to as onychomycosis or tinea unguium, which is quite common in people with HIV.

The nail may also be brittle, thickened, or have a foul odor.

Most often, nail changes are caused by a fungal infection, such as Candida, or dermatophytes. HIV weakens the immune system in people with HIV. Therefore, you may be more likely to develop a fungal infection.

Anolunula is thought to be caused by changes in the vascular or lymphatic system of people with HIV, according to the authors of one study, but this hasn’t been proven.

Nail changes may also be caused by your medications. Sometimes, the exact cause of nail changes isn’t known.

Nail changes in people with HIV can provide valuable information for treatment. Some nail changes can help inform doctors of the stage of your HIV infection.

Some nail changes, like melanonychia, are a common side effect of certain types of HIV medications. If you notice these nail changes, don’t stop taking your medication without speaking to a doctor first.

If you think you have a fungal infection of your nails, see your doctor for treatment.

Nail changes can affect anyone, but particularly people living with HIV.

While some may not require treatment, others can signal a fungal infection that needs to be treated. Always talk to your doctor about any changes you notice to your fingernails or toenails.