Biglia et al identified risk factors for gynecomastia in HIV-infected males. This can help determine the appropriate treatment strategy. The authors are from University of Barcelona in Spain.
Men with breast enlargement were confirmed as having gynecomastia using ultrasonography.
Risk factors for gynecomastia:
(1) hypogonadism, as defined by a decreased free testosterone index
(2) viral hepatitis C
(3) lipoatrophy
where:
• The formula for calculating the free testosterone index was not given. I assume it is similar to the free androgen index (in 16.23, above).
• Hypothyroidism as indicated by an elevated TSH may also be a risk factor.
Management for the gynecomastia depends on the cause:
(1) Testosterone replacement for hypogonadism.
(2) Treatment of viral hepatitis C if present.
(3) Treatment of lipoatrophy if present.
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