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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
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Atripla. Nipples. Gynecomastia?
Mar 20, 2011

I've started on HAART for the first time about 18 weeks ago. I'm taking Atripla, it's the only medication I am on or have taken for HIV. About a week ago I noticed an increased sensitivity in my left nipple and within a few days the same (if slightly less intense) sensation on my right nipple. (I can best describe the feeling as similar to the sensation one has before a zit appears - feels sensitive to the touch, a little harder than usual, but no discernible lumps or swelling. Could this be an early sign of gynecomastia? Is gynecomastia part of the side effect lipodystrophy? From browsing the forums it seems that it would be unusually early (less than 5 months on treatment) to show these signs, they seems to be associated with longer term medication. For the record, I am 30 years old, low body fat, low cholesterol, CD4 last count of 348 and RNA viral load of around 60 (most recent test taken around 1 month ago).

Response from Dr. Henry

Gynecomastia is occasionally seen in male patients starting or on antiretrovirals. Linkage to one particular drug or regimen has been hard to establish and certainly is not common, but can occur, with Atripla. The course of gynecomastia is variable (can get better or worse over time even without interventions). A clinical evaluation, hormone assessment, sometimes an ultrasound or other type of test looking a breast tissue, and waiting for several months to observe if there is improvement all are worthwhile approaches to consider. KH

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