Treatment of HIV-associated facial lipoatrophy: impact on infection progression assessed by viral load and CD4 count.
BACKGROUND
HIV/AIDS-Associated Lipodystrophy Syndrome includes changes in body fat distribution, with or without metabolic changes. The loss of fat from the face, called facial lipoatrophy, is one of the most stigmatizing signs of the syndrome.


OBJECTIVE
To evaluate the effect of FL treatment using polymethylmethacrylate (PMMA) implants on disease progression, assessed by viral load and CD4 cell count.


METHODS
This was a prospective study of 44 patients treated from July 2009 to December 2010. Male and female patients, aged over 18 years, with clinically detectable FL and who had never been treated were included in the study. PMMA implantation was done to fill atrophic areas. Laboratory tests were conducted to measure viral load and CD4 count before and after treatment.


RESULTS
Of the 44 patients, 72.72% were male and 27.27% female, mean age of 44.38 years. Before treatment, 82% of patients had undetectable viral load, which increased to 88.6% after treatment, but without statistical significance (p = 0.67). CD4 count before treatment ranged from 209 to 1293, averaging 493.97. After treatment, the average increased to 548.61. The increase in CD4 count after treatment was statistically significant with p = 0.02.


CONCLUSIONS
The treatment of FL with PMMA implants showed a statistically significant increase in CD4 count after treatment, revealing the impact of FL treatment on disease progression. Viral load before and after treatment did not vary significantly.
University of Brasilia, Department of Health of the Federal District, BrasíliaDF, Brazil.
Flávia Machado Gonçalves
FM
Soares
Izelda Maria Carvalho
IM
Costa
D000328:Adult; D001672:Biocompatible Materials / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D018450:Disease Progression; D005145:Face; D005260:Female; D039682:HIV-Associated Lipodystrophy Syndrome / Q000276:immunology / Q000628:therapy* / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D019904:Polymethyl Methacrylate / Q000627:therapeutic use*; D011446:Prospective Studies; D019736:Prostheses and Implants; D012016:Reference Values; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D019562:Viral Load
D001672:Biocompatible Materials; D019904:Polymethyl Methacrylate