title: Polyacrylamide hydrogel injection in the management of human immunodeficiency virus-related facial lipoatrophy: results of the LIPOPHILL open-label study.
abstract: Combination antiretroviral therapy (cART) can cause potentially stigmatizing facial lipoatrophy. Encouraging preliminary results have been reported with 2.5% polyacrylamide hydrogel for facial reconstruction. The aim of this multicenter, open-label noncomparative pilot study was to evaluate the efficacy and safety of intradermal facial injections of polyacrylamide hydrogel in HIV-infected patients with severe facial lipoatrophy. The patients received between two and six injections every 4 weeks, according to the aesthetic results. Clinical efficacy was evaluated by means of facial ultrasonography and photography at baseline and months 6, 12, and 24. Adverse events, patient satisfaction, and quality of life were also assessed. One hundred and eleven patients were enrolled and received at least one injection. Mean cheek skin thickness was 9.7 mm [95% CI: 9.1 to 10.2] at baseline. It rose by an average of 4.4 mm [95% CI: 3.9 to 4.9; p<0.001] at month 12 and a further 0.87 mm [95% CI: 0.52 to 1.23; p<0.001] at month 24. The Overall Treatment Satisfaction scale showed an improvement in more than 88% of patients at all visits, based on the appreciations of the patients, their close relatives and physicians, and on independent assessment of facial photographs. Quality of life improved significantly over time, as shown by the lipodystrophy-specific ABCD scale. No severe adverse effects related to the polyacrylamide hydrogel were noted. Polyacrylamide hydrogel injections were well tolerated and significantly improved the aesthetic aspect and quality of life of HIV-infected patients with facial lipoatrophy.
authors.affiliation: APHP, Service d'Immunologie Clinique, Hôpital Européen Georges Pompidou, Paris, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Mole
authors.forename: Florence
authors.initials: F
authors.lastname: Gillaizeau
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Carbonnel
authors.forename: Isabelle
authors.initials: I
authors.lastname: Pierre
authors.forename: Patricia
authors.initials: P
authors.lastname: Brazille
authors.forename: Christine
authors.initials: C
authors.lastname: Grataloup
authors.forename: Sylvie
authors.initials: S
authors.lastname: Mercier
authors.forename: Martin
authors.initials: M
authors.lastname: Duracinsky
authors.forename: Laurence
authors.initials: L
authors.lastname: Weiss
authors.forename: Christophe
authors.initials: C
authors.lastname: Piketty
mesh_terms: D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000523:psychology / Q000628:therapy*; D000180:Acrylic Resins / Q000627:therapeutic use*; D000328:Adult; D004954:Esthetics; D005145:Face; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007271:Injections, Intradermal; D008297:Male; D008875:Middle Aged; D010297:Paris / Q000453:epidemiology; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010865:Pilot Projects; D011788:Quality of Life; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000180:Acrylic Resins; C016680:polyacrylamide gels