Abstract
Introduction: We have observed a case of buffalo hump in a protease inhibitor-naive, HIV-infected hemophiliac patient.
Case Presentation: The case is a 40-year-old male patient with hemophilia B. Following treatment with ZDV and then ddC, in 1995 a treatment using d4T was initiated. In June 1997, after the treatment regimen was changed to a combination therapy using d4T and 3TC, the CD4 cell count was maintained at approximately 200-300/μl and HIV-RNA was controlled at levels below 50copies/ml. Since February 1999, however, a roughly symmetrical swelling without reddening or pain appeared on the cervical to upper dorsal region. By June, the swelling became extreme, and general malaise increased. Upon the administration of r-hGH, a significant improvement in the buffalo hump was observed. Nonetheless, approximately 2 months after stopping r-hGH due to complaints of edema and pain in the limbs, the buffalo hump reappeared.
Conclusion: We consider that the appearance of this buffalo hump is probably due to the extended administration of d4T and 3TC. The administration of r-hGH appears to be effective not only for the treatment of weight loss accompanying HIV infection but also for the treatment of buffalo hump.
