AI Article Synopsis
- A middle-aged man with HIV, stable on injectable medication, presented with painful breast enlargement and was diagnosed with idiopathic gynecomastia after ruling out other causes.
- Tamoxifen, a common treatment for gynecomastia, was noted to potentially interfere with his HIV medication, risking treatment effectiveness.
- The text discusses the use of an aromatase inhibitor as an alternative treatment for gynecomastia in HIV patients, which has not been previously reported.
Article Abstract
A middle-aged Caucasian man living with HIV, clinically stable (viral load <20 copies/mL) on injectable antiretroviral cabotegravir plus rilpivirine every 2 months presented with a 6-month history of bilateral enlargement of the breasts associated with pain. His hormonal profile was normal, and no other underlying cause was identified. He was diagnosed with idiopathic gynecomastia. Tamoxifen is an anti-oestrogen recommended for gynecomastia and has been described in people living with HIV but can potentially induce the activity of cytochrome P450 3A4 (CYP3A4), reducing rilpivirine concentrations, which consequently may cause virological failure and resistance. This is the same for other antiretroviral agents majorly induced by CYP3A4. To date, there have been no reported cases of using anastrozole as a treatment for gynecomastia in people living with HIV or of its co-administration with antiretroviral. We describe the use of an aromatase inhibitor instead of tamoxifen in a person living with HIV, diagnosed with gynecomastia.
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| http://dx.doi.org/10.1111/bcp.15951 | DOI Listing |
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Article Synopsis
- Cyclin D-dependent kinase 4/6 inhibitors, along with aromatase inhibitors and estrogen receptor degraders, are being evaluated for their effectiveness in therapeutic drug monitoring due to a lack of routine clinical methods.
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