Safety and efficacy of poly-L-lactic acid injections in persons with HIV-associated lipoatrophy: the US experience.
BACKGROUND
With the introduction of highly active antiretroviral therapy (HAART), HIV/AIDS has become a more chronic disease. This increase in survival, however, has been accompanied by the occurrence of metabolic and morphologic changes known collectively as HIV-associated lipodystrophy.


OBJECTIVE
The objective was to evaluate the quantifiable improvement in facial wasting (lipoatrophy) after serial injections of poly-L-lactic acid (PLLA) as well as the long-term safety and durability of this material.


METHODS
A single-site, open-label study in which patients received up to six treatment sessions of injectable PLLA. Patients were followed for 12 months after treatment. Patients were evaluated for increase in total cutaneous thickness by skin calipers. Serial photographs and patient satisfaction and patient well-being questionnaires were undertaken throughout the study period.


RESULTS
Patients at the end of treatment exhibited a mean increase in skin thickness of 65.1% compared with baseline values. This correction was maintained throughout the 12-month follow-up period (68.8% at 6 months and 73% at 12 months). On a one to five scale, patient satisfaction was 4.5 at the end of treatment and increased to 4.8 at 12-month follow-up. No serious adverse events were reported.


CONCLUSIONS
PLLA is a safe and well-tolerated treatment option for HIV-associated lipoatrophy.
Mest
Douglas R
DR
Blue Pacific Aesthetic Medical Group, El Segundo, California 90245, USA. drmest@aol.com
Humble
Gail
G
D000328:Adult; D000368:Aged; D001672:Biocompatible Materials / Q000008:administration & dosage*; D003357:Cosmetic Techniques; D005145:Face / Q000473:pathology / Q000601:surgery*; D039682:HIV-Associated Lipodystrophy Syndrome / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007279:Injections, Subcutaneous; D019344:Lactic Acid / Q000008:administration & dosage*; D008875:Middle Aged; D017060:Patient Satisfaction; D011091:Polyesters; D011108:Polymers / Q000008:administration & dosage*; D016896:Treatment Outcome
D001672:Biocompatible Materials; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)