title: Poly-L-lactic acid for treating HIV-associated facial lipoatrophy: a review of the clinical studies.
abstract: Facial lipoatrophy can be associated with human immunodeficiency virus (HIV), impacting severely on quality of life. Various treatments have been investigated, including poly-L-lactic acid (PLLA). Four studies have investigated the efficacy of PLLA in the correction of HIV-associated facial lipoatrophy. The studies: VEGA, Chelsea and Westminster, APEX002 and Blue Pacific involved 50, 30, 99 and 99 patients, respectively, exhibiting HIV-associated facial lipoatrophy. Follow-up ranged from 24-96 weeks. Measures of treatment efficacy included ultrasound and subjective measures. Significant, long-lasting increases in dermal thickness were recorded and in all four studies, a subjective improvement was reported by patients and investigators in facial appearance and quality of life. Treatment was well tolerated. Small, non-bothersome subcutaneous papules were the only device-related adverse events observed. PLLA represents a promising treatment option for HIV-associated facial lipoatrophy. The procedure requires minimal "downtime" and provides long-lasting results without the need for invasive surgery.
authors.affiliation: Department of HIV/Genitourinary Medicine, Chelsea and Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK. simon.barton@chelwest.nhs.uk
authors.forename: S E
authors.initials: SE
authors.lastname: Barton
authors.forename: P
authors.initials: P
authors.lastname: Engelhard
authors.forename: M
authors.initials: M
authors.lastname: Conant
mesh_terms: D002986:Clinical Trials as Topic; D005145:Face / Q000000981:diagnostic imaging; D005260:Female; D015658:HIV Infections / Q000150:complications*; D015497:HIV-1; D039682:HIV-Associated Lipodystrophy Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy*; D006801:Humans; D019344:Lactic Acid / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome; D014463:Ultrasonography
chemical_list: D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)