| Abstract | The prognosis of HIV infection has improved dramatically since the introduction of highly active antiretroviral therapy (HAART). However, numerous adverse effects and limitations regarding tolerability remain a concern. Lipomastia (pseudogynecomastia), a breast enlargement due to central adiposity, may occur as part of a fat redistribution syndrome which has been associated with HAART regimens and several pathogenic mechanisms have been advocated in its development. Here we report an observational longitudinal study of five patients diagnosed of gynecomastia associated with efavirenz-based HAART regimens. All cases reached successful immunologic and virologic responses to HAART. The delay of appearance of gynecomastia from the beginning of HAART ranged between 4 to 15 months. In all five cases, gynecomastia regressed after efavirenz withdrawal (mean period of 5 months). In summary, we think that HAART induced gynecomastia should be suspected in HIV patients receiving efavirenz-containing regimens. Although pathogenesis is unclear, this study and a review of the English literature implicates two possible mechanisms: (a) immune restoration processes and (b) efavirenz mediated estradiol-like effects. |
| Authors | Francisco Jover, José M Cuadrado, Pablo Roig, Marta Rodríguez, Lucio Andreu, Jaime Merino
(Affiliation: Infectious Diseases Division, Internal Medicine Department, Hospital of San Juan, Alicante, Spain. fjoverdiaz at coma.es)
|
| Journal | The breast journal
(Breast J)
2004 May-Jun
Vol. 10
Issue 3
Pg. 244-6
ISSN: 1075-122X United States |
| PMID | 15125753
(Publication Type: Case Reports, Journal Article, Review)
|
| Chemical References |
- Anti-HIV Agents
- Benzoxazines
- Oxazines
- Reverse Transcriptase Inhibitors
- efavirenz
|
| Topics |
- Adult
- Anti-HIV Agents
(administration & dosage, adverse effects)
- Antiretroviral Therapy, Highly Active
(adverse effects)
- Benzoxazines
- Female
- Gynecomastia
(chemically induced, diagnosis, metabolism)
- HIV Infections
(drug therapy)
- HIV-Associated Lipodystrophy Syndrome
(chemically induced, diagnosis)
- Humans
- Longitudinal Studies
- Male
- Middle Aged
- Oxazines
(administration & dosage, adverse effects)
- Reverse Transcriptase Inhibitors
(administration & dosage, adverse effects)
- Risk Factors
- Time Factors
|
