Report of gynecomastia in five male patients during antiretroviral therapy for HIV infection

Peyrière, Hélène; Mauboussin, Jean-Marc; Rouanet, Isabelle; Merle, Corinne; Sotto, Albert; Arnaud, Anne; Hillaire‐Buys, Dominique; Balmès, P

doi:10.1097/00002030-199910220-00022

Cited by 32 publications

(32 citation statements)

References 4 publications

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“…Medicamentos como cetoconazol, cimetidina e hormônios esteroides também estão implicados (5). Recentemente, têm sido relatados casos de ginecomastia em homens em uso de inibidores de protease (IPs) (29)(30)(31). Os mecanismos não estão elucidados, mas estudos in vitro demonstram aumento da metabolização da testosterona livre em hepatócitos.…”

Section: Ginecomastia E Hiperprolactinemiaunclassified

Disfunção do eixo gonadotrófico em homens com infecção pelo HIV/Aids

Ponte

Gurgel

Montenegro

2009

Arq Bras Endocrinol Metab

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RESUMOA disfunção do eixo gonadotrófico é frequentemente observada em pacientes infectados pelo HIV. A patogênese é multifatorial e está relacionada à duração da infecção pelo HIV, aos efeitos citopáticos diretos do vírus, ao uso de drogas gonadotóxicas, às infecções oportunistas, às neo plasias, à desnutrição, entre outros fatores. Em homens, a redução dos níveis de testosterona está associada à perda de massa e de força muscular, à redução da densidade mineral óssea, à lipodistrofia, à depressão, à astenia, à fadiga e à disfunção sexual. Em pacientes infectados pelo HIV com hipogonadismo, inúmeros estudos têm comprovado os efeitos benéficos da reposição de testosterona sobre o perfil metabólico e a distribuição da gordura corporal, com aumento da massa corporal magra, além de promover melhora da qualidade de vida, reduzir a perda de mas sa óssea e reduzir os índices de depressão. Assim, esta revisão teve como objetivo trazer uma breve atualização sobre o presente tema, abordando dados epidemiológicos, mecanismos fisio patológicos e estratégias terapêuticas para as principais anormalidades do eixo gonadotrófico masculino associadas à infecção pelo HIV e ao seu tratamento. ABSTRACTGonadotrophic axis dysfunction is commonly observed in HIVinfected patients. The pathogen esis is multifactorial and related to duration of HIV infection, direct cytopathic effects of viruses, use of drugs, opportunistic infections, malignancies, and malnutrition, among other factors. In men, reduced levels of testosterone is associated with loss of muscle mass and strength, de creased bone mineral density, lipodystrophy, depression, asthenia, fatigue and sexual dysfunc tion. In HIVinfected patients with hypogonadism, numerous studies have shown the beneficial effects of testosterone replacement on the metabolic profile and distribution of body fat, with increased body mass weight, and promote better quality of life, reduce the bone mass loss and the rates of depression. Thus, this review aimed to present a brief update of epidemiologic data, pathophysiology aspects and treatment strategies for the major abnormalities of male gonado trophic axis associated with HIV infection and its treatment. Arq Bras Endocrinol Metab. 2009;53(8):983-8

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Section: Ginecomastia E Hiperprolactinemiaunclassified

Disfunção do eixo gonadotrófico em homens com infecção pelo HIV/Aids

Ponte

Gurgel

Montenegro

2009

Arq Bras Endocrinol Metab

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“…Since then there has been an increasing number of reports in the medical literature, suggesting that breast enlargement could present as a late side effect of HAART (2)(3)(4)(5)(6).…”

Section: Discussionmentioning

confidence: 99%

HIV infected haemophilia a patient presented with gynaecomastia

Chalazonitis

Sotiropoulou²,

Ptohis³

et al. 2007

Diagn Interv Radiol

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“…HAART has been associated with both lipomastia and gynecomastia in multiple case reports [3][4][5][6][7][8][9][10][11][12]. Lipomastia in HIV-infected patients is considered to be secondary to the metabolic derangements of the fat maldistribution syndrome [13].…”

Section: Discussionmentioning

confidence: 99%

“…It remained a rarely diagnosed condition until the widespread use of HAART began nearly a decade later. Since 1997, there have been multiple reports of breast enlargement in HIV-infected men, most often in association with protease inhibitorbased regimens [3][4][5][6][7][8][9][10][11][12]. However, a clear distinction between true gynecomastia and lipomastia was not made for many of these reported cases, leaving uncertain the true frequency and pathogenesis of each condition.…”

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confidence: 99%

Breast Enlargement in 13 Men Who Were Seropositive for Human Immunodeficiency Virus

et al. 2002

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Breast enlargement, a condition that was rarely reported in the era before highly active antiretroviral therapy, is emerging as a problem in the treatment of male human immunodeficiency virus (HIV)-infected patients. Evaluation of this condition must distinguish between gynecomastia (proliferation of ducts and periductal stroma), lipomastia (adipose-tissue deposition), and malignancy. We describe 13 HIV-infected men, all of whom had exposure to antiretroviral therapy, who presented with breast enlargement. Nine of these patients had gynecomastia, only 1 had lipomastia, and 3 had lymphoma (2 had non-Hodgkin lymphoma and 1 had Hodgkin disease). Gynecomastia was unilateral in all but a single case. In addition, all but 1 of our patients with gynecomastia had prolonged exposure to protease inhibitors. Six patients had potential causes of gynecomastia other than antiretroviral therapy, including liver disease (in 2 patients), mild hypogonadism (in 1), long-term marijuana use (in 2), and use of medications that have known associations with gynecomastia (in 3). Although most causes of breast enlargement in HIV-infected men are likely to be benign, malignancies other than carcinoma are of concern.

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Report of gynecomastia in five male patients during antiretroviral therapy for HIV infection

Cited by 32 publications

References 4 publications

Disfunção do eixo gonadotrófico em homens com infecção pelo HIV/Aids

Disfunção do eixo gonadotrófico em homens com infecção pelo HIV/Aids

HIV infected haemophilia a patient presented with gynaecomastia

Breast Enlargement in 13 Men Who Were Seropositive for Human Immunodeficiency Virus

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