GYNECOMASTIA

Mar 28, 2002

Hi, I am a 49 yr old male who just developed painful lumps under my breasts that my doctor said is gynecomastia. I have been poz for 10yrs, drug regimen was crix/zerit/epivir for 7 yrs till lipo developed. Changed to videx ec, ziagen, sustiva after a 10 wk STI. My dr thinks this problem was caused by ziagen and should disappear in a few months. Switched to viread, videx, sustiva and still have problem after almost 2 months. Have you seen any meds cause this painful condition???? What can be done? I AM WORRIED.... Thanks for your help. C.J.

Response from Dr. Boyle

Gynecomastia is a form of fat accumulation and it is associated with antiretroviral therapy, and especially regimens that include a protease inhibitor. This condition does not resolve quickly when the medications are discontinued or changed so I am not surprised that it is persistent despite your regimen changes. There are some treatment options (e.g., growth hormone) but these are difficult and expensive to use and the fat generally comes back once the therapy is stopped. You should discuss potential treatment options with your doctor. You should also be evlauated to make sure that it is HIV/antiretroviral-realted fat accumulation and that there is no other problem present.