Osteosclerosis and Periosteal New Bone Formation During Indinavir Therapy

The document described a case of a 56-year-old HIV-1-infected man who developed osteosclerosis and periostal new bone formation after 27 months of indinavir therapy, alongside multivitamin use containing vitamin A. The patient experienced symptoms such as dry skin, ingrown toenails, and hair loss, which are similar to side effects of systemic retinoid therapy. The study suggested that the retinoid effect of indinavir, enhanced by vitamin A, was a significant factor in these bone changes. After switching from indinavir to nelfinavir, the patient's bone abnormalities reduced. This case highlighted potential differences in bone metabolism effects between indinavir and nelfinavir, and it raised concerns about indinavir use with vitamin A and during pregnancy.