Retinoic acid

Retinoic acid is a derivative of vitamin A. Two treatment forms of retinoic acid have been developed - all-trans retinoic acid and 9-cis retinoic acid.

All-trans retinoic acid influences the development of skin cells in laboratory studies. It is being examined as a potential treatment for Kaposi’s sarcoma, with encouraging results. Furthermore, there is preliminary evidence that all-trans retinoic acid may slow down cell death associated with HIV disease.1

9-cis retinoic acid comes as either a topical gel or an oral formulation. The gel has been found to be moderately effective in treating Kaposi’s sarcoma lesions independently of CD4 cell count and antiretroviral therapy, producing a positive response in around a third of patients.2 3 In the United States, it was approved as a treatment for Kaposi’s sarcoma lesions in November 1998. The gel, known by the brand name Panretin, was developed by Ligand Pharmaceuticals.

Mild side-effects to the gel, primarily skin irritation, are common. Other common side-effects associated with the oral formulation are headache, dry or peeling skin, hair loss and high blood lipids. Rare cases of pancreatitis have been reported among people on high doses.

A capsule formulation of 9-cis retinoic acid has been tested for Kaposi’s sarcoma, but the side-effects, particularly headache, made it intolerable for most patients.4 5


  1. Szondy Z et al. All-trans retinoic acid inhibition of anti-CD3-induced T cell apoptosis in HIV infection mostly concerns CD4 T lymphocytes and is mediated via regulation of CD95 ligand expression. J Infect Dis 178: 1288-1298, 1998
  2. Walmsley S et al. Treatment of AIDS-related cutaneous Kaposi's sarcoma with topical alitretinoin (9-cis-retinoic acid) gel. Panretin Gel North American Study Group. J Acquir Immune Defic Syndr 22: 235-246, 1999
  3. Duvic M et al. Topical treatment of cutaneous lesions of acquired immunodeficiency syndrome-related Kaposi sarcoma using alitretinoin gel: results of phase 1 and 2 trials. Arch Dermatol 136: 1461-1469, 2000
  4. Miles SA et al. Antitumor activity of oral 9-cis-retinoic acid in HIV-associated Kaposi’s sarcoma. AIDS 16: 421-429, 2002
  5. Aboulafia DM et al. 9-cis-retinoic acid capsules in the treatment of AIDS-related Kaposi’s sarcoma: results of a phase 2 multicenter clinical trial. Arch Dermatol 139: 178-186, 2003

Community Consensus Statement on Access to HIV Treatment and its Use for Prevention

Together, we can make it happen

We can end HIV soon if people have equal access to HIV drugs as treatment and as PrEP, and have free choice over whether to take them.

Launched today, the Community Consensus Statement is a basic set of principles aimed at making sure that happens.

The Community Consensus Statement is a joint initiative of AVAC, EATG, MSMGF, GNP+, HIV i-Base, the International HIV/AIDS Alliance, ITPC and NAM/aidsmap

This content was checked for accuracy at the time it was written. It may have been superseded by more recent developments. NAM recommends checking whether this is the most current information when making decisions that may affect your health.

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