title: Breast enlargement in 13 men who were seropositive for human immunodeficiency virus.
abstract: 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.
authors.affiliation: Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
authors.forename: Devon L
authors.initials: DL
authors.lastname: Evans
authors.forename: Liron
authors.initials: L
authors.lastname: Pantanowitz
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Dezube
authors.forename: David M
authors.initials: DM
authors.lastname: Aboulafia
mesh_terms: D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000009:adverse effects* / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D001943:Breast Neoplasms / Q000139:chemically induced / Q000276:immunology; D015897:Comorbidity; D006177:Gynecomastia / Q000139:chemically induced*; D015658:HIV Infections / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D008223:Lymphoma / Q000139:chemically induced / Q000276:immunology; D008297:Male; D008875:Middle Aged
chemical_list: D019380:Anti-HIV Agents