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Efavirenz/lamivudine/stavudine Gynaecomastia: case report A 24-year-old man with HIV infection developed gynaecomastia during antiretroviral therapy with stavudine, lamivudine and efavirenz. The man, who had haemophilia A, hepatitis C and a 22-year history of HIV, presented with bilateral breast enlargement that had developed over the last six months. He had been receiving stavudine, lamivudine and efavirenz [dosages not stated] for 3 years. He had a CD4+ cell count of 432 cells/µL and HIV-RNA of 42 000 copies/mL. A mammogram showed enlargement in both breasts with the presence of glandular tissue. Round microcalcifications in the upper outer quadrant of both breasts were also observed. An MR mammogram showed breast glandular tissue producing low signal intensity with T1-weighted and T2-weighted images and a MR mammogram with fat saturation sequence showed the presence of enlarged glandular tissue. The man was followed with close observation. After three and six months, the mammographic findings remained stable. Author comment: "In our case, the long-lasting use of antiretroviral drugs is implicated as the precipitating cause for the development of gynecomastia." Chalazonitis A, et al. HIV-infected hemophilia a patient presenting with gynecomastia. Diagnostic and Interventional Radiology 15: 242-6, No. 4, Dec 2009 803018314 - Greece

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Reactions 12 Jun 2010 No. 1305