title: Quality of life outcomes associated with treatment of human immunodeficiency virus (HIV) facial lipoatrophy.
abstract: Facial lipoatrophy (FLA), characterized by a decrease in facial volume, has a high prevalence in patients with human immunodeficiency virus (HIV) infection treated with long-term highly active antiretroviral therapy (HAART). The social stigmatization that results from such changes in facial appearance has led some HIV patients to discontinue HAART. The use of fillers is one method of restoring facial volume. A critical outcome of treatment concerns the patient's quality of life (QoL). Although many studies have assessed patient satisfaction, as well as the social and psychological outcomes associated with the correction of HIV FLA, fewer studies have assessed QoL. We reviewed treatment options for HIV FLA with a specific focus on QoL outcomes. Our analysis revealed that the following treatments were associated with improvements in QoL: poly-l-lactic acid; calcium hydroxylapatite; hyaluronic acid; polyacrylamide gel; polyalkylamide gel; polymethylmethacrylate; silicone oil; and autologous fat transfer. The treatment of HIV FLA with these agents appears to improve QoL as assessed by various QoL instruments. Additional studies are required to identify a unifying QoL instrument to effectively assess longitudinal QoL outcomes and to compare treatment modalities.
authors: School of Medicine, Georgetown University, Washington, DC, USA.
authors: Christina N
authors: CN
authors: Kraus
authors: Department of Dermatology, University of California Irvine, Irvine, CA, USA. lchapman@uci.edu.
authors: Lance W
authors: LW
authors: Chapman
authors: Department of Dermatology, University of California Irvine, Irvine, CA, USA.
authors: Dorota Z
authors: DZ
authors: Korta
authors: Department of Dermatology, University of California Irvine, Irvine, CA, USA.
authors: Christopher B
authors: CB
authors: Zachary
mesh_terms: D000180:Acrylic Resins / Q000627:therapeutic use; D000273:Adipose Tissue / Q000637:transplantation; D000067548:Dermal Fillers / Q000009:adverse effects / Q000627:therapeutic use*; D017886:Durapatite / Q000627:therapeutic use; D005145:Face; D039682:HIV-Associated Lipodystrophy Syndrome / Q000523:psychology* / Q000628:therapy*; D006801:Humans; D006820:Hyaluronic Acid / Q000627:therapeutic use; D011091:Polyesters / Q000627:therapeutic use; D019904:Polymethyl Methacrylate / Q000627:therapeutic use; D011788:Quality of Life; D012827:Silicone Oils / Q000627:therapeutic use
chemical_list: D000180:Acrylic Resins; D000067548:Dermal Fillers; D011091:Polyesters; D012827:Silicone Oils; C016680:polyacrylamide gels; C033616:poly(lactide); D006820:Hyaluronic Acid; D019904:Polymethyl Methacrylate; D017886:Durapatite