Journal Article

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

Devon L. Evans, Liron Pantanowitz, Bruce J. Dezube and David M. Aboulafia

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 9, pages 1113-1119
Published in print November 2002 | ISSN: 1058-4838
Published online November 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/343045
Breast Enlargement in 13 Men Who Were Seropositive for Human Immunodeficiency Virus

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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.

Journal Article.  3277 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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