Hyaluronic acid treatment of facial fat atrophy in HIV-positive patients.
OBJECTIVE
Facial lipoatrophy can be devastating for HIV-infected patients, with negative effects on self-esteem. In this study, we treated facial fat atrophy in the nasogenian area with hyaluronic acid (Restylane SubQ; Q-Med AB, Uppsala, Sweden).


METHODS
Twenty patients were included in the study. Treatment effects were evaluated at baseline, and at weeks 6, 24 and 52 using ultrasound, the Global Aesthetic Improvement Scale, the Visual Analogue Scale and the Rosenberg Self-Esteem Scale.


RESULTS
Mean (+/-standard deviation) total cutaneous thickness increased from 6+/-1 mm at baseline to 15+/-3 mm at week 6 (P<0.001), and declined to 10+/-2 mm at week 52 (P<0.001 vs baseline). The response rate (total cutaneous thickness >10 mm) was 100% at week 6, 85% at week 24 and 60% at week 52. At week 6, all of the patients classified their facial appearance as very much improved or moderately improved. They also reported increased satisfaction with their facial appearance and had higher self-esteem scores. At week 52, 15 of 19 patients still classified their facial appearance as very much improved or moderately improved, although the mean total cutaneous thickness had gradually declined.


CONCLUSIONS
Our results indicate that Restylane SubQ is a useful and well-tolerated dermal filler for treating HIV-positive patients with facial lipoatrophy.
Bugge
H
H
Department of Plastic Surgery, Ulleval University Hospital, N-0407 Oslo, Norway.
Negaard
A
A
Skeie
L
L
Bergersen
B
B
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D044966:Anti-Retroviral Agents / Q000009:adverse effects*; D005150:Facial Hemiatrophy / Q000188:drug therapy* / Q000523:psychology / Q000821:virology; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000523:psychology; D006801:Humans; D006820:Hyaluronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012649:Self Concept; D016896:Treatment Outcome
D000276:Adjuvants, Immunologic; D044966:Anti-Retroviral Agents; D006820:Hyaluronic Acid; C445361:Restylane