Cases of antiretroviral-associated gynaecomastia reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa

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dc.contributor.authorNjuguna, Christine
dc.contributor.authorSwart, Annoesjka
dc.contributor.authorBlockman, Marc
dc.contributor.authorMaartens, Gary
dc.contributor.authorChisholm, Briony
dc.contributor.authorStewart, Annemie
dc.contributor.authorUys, Anri
dc.contributor.authorCohen, Karen
dc.date.accessioned2021-10-08T11:00:53Z
dc.date.available2021-10-08T11:00:53Z
dc.date.issued2016
dc.description.abstractAbstract Background Gynaecomastia is associated with exposure to antiretroviral therapy (ART), in particular efavirenz. There is limited data on clinical characteristics of patients with ART-associated gynaecomastia in resource-limited settings and little guidance on the optimal management of this adverse drug reaction (ADR). We describe the clinical characteristics, management and outcomes of gynaecomastia cases reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa. Methods We identified all gynaecomastia cases in adolescent boys and men on ART reported to the hotline between June 2013 and July 2014. We collected follow up data telephonically at monthly intervals to document clinical management and outcomes. Results We received 51 reports of gynaecomastia between June 2013 and July 2014; 11% of the 475 patient-specific ADR queries to the hotline. All patients were on efavirenz-based ART. Mean age was 34 years (standard deviation 12) and seven were adolescents. The median onset of gynaecomastia was 15 months after efavirenz initiation (interquartile range 6–42). Gynaecomastia was bilateral in 29 patients (57%) and unilateral in 16 (31%). Serum testosterone was quantified in 25 of 35 patients with follow up data, and was low in 2 (8%). Efavirenz was replaced with an alternative antiretroviral in 29/35 patients (83%) and gynaecomastia improved in 20/29 (69%). Conclusions Gynaecomastia was a frequently reported ADR in our setting, occurring with prolonged efavirenz exposure. Testosterone was low in the minority of tested cases. Most clinicians elected to switch patients off efavirenz, and gynaecomastia improved in the majority.
dc.identifier.apacitationNjuguna, C., Swart, A., Blockman, M., Maartens, G., Chisholm, B., Stewart, A., ... Cohen, K. (2016). Cases of antiretroviral-associated gynaecomastia reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa. <i>AIDS Research and Therapy</i>, 13(1), 174 - 177. http://hdl.handle.net/11427/35040en_ZA
dc.identifier.chicagocitationNjuguna, Christine, Annoesjka Swart, Marc Blockman, Gary Maartens, Briony Chisholm, Annemie Stewart, Anri Uys, and Karen Cohen "Cases of antiretroviral-associated gynaecomastia reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa." <i>AIDS Research and Therapy</i> 13, 1. (2016): 174 - 177. http://hdl.handle.net/11427/35040en_ZA
dc.identifier.citationNjuguna, C., Swart, A., Blockman, M., Maartens, G., Chisholm, B., Stewart, A., Uys, A. & Cohen, K. et al. 2016. Cases of antiretroviral-associated gynaecomastia reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa. <i>AIDS Research and Therapy.</i> 13(1):174 - 177. http://hdl.handle.net/11427/35040en_ZA
dc.identifier.issn1742-6405
dc.identifier.ris TY - Journal Article AU - Njuguna, Christine AU - Swart, Annoesjka AU - Blockman, Marc AU - Maartens, Gary AU - Chisholm, Briony AU - Stewart, Annemie AU - Uys, Anri AU - Cohen, Karen AB - Abstract Background Gynaecomastia is associated with exposure to antiretroviral therapy (ART), in particular efavirenz. There is limited data on clinical characteristics of patients with ART-associated gynaecomastia in resource-limited settings and little guidance on the optimal management of this adverse drug reaction (ADR). We describe the clinical characteristics, management and outcomes of gynaecomastia cases reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa. Methods We identified all gynaecomastia cases in adolescent boys and men on ART reported to the hotline between June 2013 and July 2014. We collected follow up data telephonically at monthly intervals to document clinical management and outcomes. Results We received 51 reports of gynaecomastia between June 2013 and July 2014; 11% of the 475 patient-specific ADR queries to the hotline. All patients were on efavirenz-based ART. Mean age was 34 years (standard deviation 12) and seven were adolescents. The median onset of gynaecomastia was 15 months after efavirenz initiation (interquartile range 6–42). Gynaecomastia was bilateral in 29 patients (57%) and unilateral in 16 (31%). Serum testosterone was quantified in 25 of 35 patients with follow up data, and was low in 2 (8%). Efavirenz was replaced with an alternative antiretroviral in 29/35 patients (83%) and gynaecomastia improved in 20/29 (69%). Conclusions Gynaecomastia was a frequently reported ADR in our setting, occurring with prolonged efavirenz exposure. Testosterone was low in the minority of tested cases. Most clinicians elected to switch patients off efavirenz, and gynaecomastia improved in the majority. DA - 2016 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - AIDS Research and Therapy LK - https://open.uct.ac.za PY - 2016 SM - 1742-6405 T1 - Cases of antiretroviral-associated gynaecomastia reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa TI - Cases of antiretroviral-associated gynaecomastia reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa UR - http://hdl.handle.net/11427/35040 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/35040
dc.identifier.vancouvercitationNjuguna C, Swart A, Blockman M, Maartens G, Chisholm B, Stewart A, et al. Cases of antiretroviral-associated gynaecomastia reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa. AIDS Research and Therapy. 2016;13(1):174 - 177. http://hdl.handle.net/11427/35040.en_ZA
dc.language.isoeng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.sourceAIDS Research and Therapy
dc.source.journalissue1
dc.source.journalvolume13
dc.source.pagination174 - 177
dc.source.urihttps://dx.doi.org/10.1186/s12981-016-0121-z
dc.subject.otherAntiretroviral therapy
dc.subject.otherEfavirenz
dc.subject.otherGynaecomastia
dc.subject.otherSouth Africa
dc.subject.otherAdolescent
dc.subject.otherAdult
dc.subject.otherAnti-HIV Agents
dc.subject.otherAntiretroviral Therapy, Highly Active
dc.subject.otherBenzoxazines
dc.subject.otherChild
dc.subject.otherGynecomastia
dc.subject.otherHIV Infections
dc.subject.otherHealth Personnel
dc.subject.otherHotlines
dc.subject.otherHumans
dc.subject.otherMale
dc.subject.otherMiddle Aged
dc.subject.otherSouth Africa
dc.titleCases of antiretroviral-associated gynaecomastia reported to the National HIV & Tuberculosis Health Care Worker Hotline in South Africa
dc.typeJournal Article
uct.type.publicationResearch
uct.type.resourceJournal Article
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