Evaluation of injectable calcium hydroxylapatite for the treatment of facial lipoatrophy associated with human immunodeficiency virus.
OBJECTIVE
To evaluate the safety and effectiveness of soft tissue augmentation with calcium hydroxylapatite (CaHA) microspheres in an aqueous gel in patients with facial lipoatrophy (FLA) secondary to human immunodeficiency virus (HIV) disease.


METHODS
This 12-month open-label, prospective study enrolled 30 subjects (29 men and 1 woman) with HIV-associated FLA. After the initial treatment phase (up to 2 injections, 30 days apart), patients were followed up at 3, 6, and 12 months. Patients were offered touch-up injections at 6 and 12 months. Measurements included confirmed changes in the Global Aesthetic Improvement Scale and in cheek thickness.


RESULTS
Average initial treatment volume was 9.5 mL per patient (both sides); total volumes per patient after 12 months averaged 16.1 mL. At all time points, all patients were rated as improved or better and responded affirmatively to satisfaction questions. Cheek thickness measurements increased substantially over baseline (p<.001). Most commonly reported adverse events were edema (93%), ecchymosis (83%), and erythema (77%).


CONCLUSIONS
CaHA is an appropriate and well-tolerated treatment for patients with HIV-associated FLA. With an excellent safety profile, CaHA provides immediate correction of FLA and appears to provide lasting improvement in appearance.
Carruthers
Alastair
A
Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada. alastair@carruthers.net
Carruthers
Jean
J
D001284:Atrophy / Q000628:therapy; D001672:Biocompatible Materials / Q000008:administration & dosage* / Q000009:adverse effects; D017886:Durapatite / Q000008:administration & dosage* / Q000009:adverse effects; D005145:Face; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007279:Injections, Subcutaneous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D050151:Subcutaneous Fat / Q000473:pathology*
D001672:Biocompatible Materials; D017886:Durapatite