Will enlarged breast/ fat pad decrease after I switch from Sustiva?

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CASE REPORT

Efavirenz-Associated Gynecomastia: Report of Five Cases and Review of the Literature

Francisco Jover, MD , José M. Cuadrado, MD , Pablo Roig, MD , Marta Rodríguez, MD , Lucio Andreu, MD and Merino

Infectious Diseases Division, Internal Medicine Department, Hospital of San , Alicante, Spain

Address correspondence and reprint requests to: Francisco Jover Díaz, MD, C/Madre de Calcuta N°4, Bloque 4, Esc 1, 2° H. 03016, Alicante, Spain, or e-mail: fjoverdiaz@....

Abstract:

Abstract: The prognosis of HIV infection has improved dramatically since the introduction of highly active antiretroviral therapy (HAART). However, numerous adverse effects and limitations regarding tolerability remain a concern. Lipomastia (pseudogynecomastia), a breast enlargement due to central adiposity, may occur as part of a fat redistribution syndrome which has been associated with HAART regimens and several pathogenic mechanisms have been advocated in its development. Here we report an observational longitudinal study of five patients diagnosed of gynecomastia associated with efavirenz-based HAART regimens. All cases reached successful inmunologic and virologic responses to HAART. The delay of appearance of gynecomastia from the beginning of HAART ranged between 4 to 15 months. In all five cases, gynecomastia regressed after efavirenz withdrawal (mean period of 5 months). In summary, we think that HAART induced gynecomastia should be suspected in HIV patients receiving efavirenz-containing regimens. Although pathogenesis is unclear, this study and a review of the English literature implicates two possible mechanisms: (a) immune restoration processes and ( efavirenz mediated estradiol-like effects.

Regards, VergelDirectorProgram for Wellness Restorationpowerusa dot org

In a message dated 9/2/2008 4:06:45 P.M. Central Daylight Time, bmailman@... writes:

simon collins wrote:> As efavirenz has been linked to gynaecomastia for many years ...Does going off it, resolve the issue?B/It's only a deal if it's where you want to go. Find your travel deal here.