Hyaluronic Acid New Formulation: Experience in HIV-Associated Facial Lipoatrophy

Bechara, Falk G.; Gambichler, Thilo; Brockmeyer, Norbert H.; Sand, Michael; Altmeyer, Peter; Hoffmann, Klaus

doi:10.1159/000148252

Cited by 35 publications

(41 citation statements)

References 49 publications

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“…After treatment with large particle hyaluronic acid, persistent improvements in cheek augmentation of HIVpositive patients have been reported up to 12 months posttreatment [14,15]. Similar long-term effects with Restylane SubQ treatment in non-HIV-positive patients of up to 12 months have been described for cheek and chin augmentation [13,19] and in a small study on orbital volume enhancement [22].…”

Section: Durabilitymentioning

confidence: 63%

“…Polylactic acid needs multiple treatment sessions in order to obtain the desired effect and is usually administered every 2 to 4 weeks over three to six sessions to obtain optimal results [15]. It may take several months for the treatment results with polylactic acid to stabilize and for the full magnitude of the facial augmentation to become apparent [24].…”

Section: Other Soft-tissue Fillersmentioning

confidence: 99%

“…As a result of this, the gel can be injected in larger amounts and into deeper skin layers [13], an advantage given that HIV facial lipoatrophy typically involves larger atrophic surface areas than seen in the general population. The use of a more viscous type of hyaluronic acid for the treatment of HIV-associated lipoatrophy has only been described previously in two studies, both with a follow-up period of 12 months [14,15]. The aim of our study was to evaluate the efficacy, safety and durability of a large particle hyaluronic acid in the correction of facial lipoatrophy in HIV-infected patients over a 3-year period.…”

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confidence: 99%

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Large particle hyaluronic acid for the treatment of facial lipoatrophy in HIV‐positive patients: 3‐year follow‐up study

Skeie¹,

Bugge

Negaard

et al. 2010

HIV Medicine

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ObjectivesFacial lipoatrophy can be a stigmatizing side effect of antiretroviral (AVR) treatment for HIV-infected patients. We sought to evaluate the long-term efficacy and safety of a new formulation of hyaluronic acid that can be injected in larger amounts and into deeper skin layers during 3 years of follow-up. Methods Twenty patients received injections of Restylane SubQ 2. Refill treatment was offered at 12 and 24 months. Treatment effects were evaluated using ultrasound, the Global Aesthetic Improvement Scale, visual analogue scale (VAS) and the Rosenberg self-esteem scale. ResultsSeventeen patients remained at 36 months. Mean (AE standard deviation) total cutaneous thickness increased from 6 AE 1 mm at baseline to 12 AE 1 mm (Po0.001) at 36 months. Response rate (total cutaneous thickness 410 mm) was 70%. Fifteen patients classified their facial appearance as very much or moderately improved. VAS increased from 39 AE 25 to 70 AE 20 (Po0.05) and higher self-esteem scores were reported. Local swelling and tenderness after treatment was common. Persistent papules found in several patients after treatment were removed effectively with hyaluronidase injections. Three patients, treated only at baseline, still had higher total cutaneous thickness scores at 36 months. ConclusionsOur results indicate that a large particle hyaluronic acid formulation is a durable and well-tolerated dermal filler for treating HIV-positive patients with facial lipoatrophy. IntroductionLipoatrophy is a particularly distressing aspect of lipodystrophy evident in HIV-positive patients on antiretroviral therapy (ART). Facial lipoatrophy can severely affect patients' quality of life and may contribute to reduced antiretroviral (AVR) adherence [1]. Furthermore, the stigmatization affected patients may encounter as a result of facial lipoatrophy can be detrimental for self-esteem [2]. Treatment strategies include switching AVR regimens, prescription of medication, insertion of surgical implants and injection of dermal fillers.While there is evidence that the use of new nonthymidine nucleoside reverse transcriptase inhibitors can prevent the development of lipoatrophy, switching medications, after lipoatrophy has progressed, offers only limited benefit [3,4]. A follow-up study of the Oslo HIV Cohort Study 2000 found that facial atrophy was less reversible than fat atrophy of the extremities [5]. Medications such as pioglitazone [6], uridine [7] and pravastatin [8] have been shown to have some effect on limb lipoatrophy in HIV-infected patients; however, the mechanisms by which they work and their potential side effects are not well documented.In the absence of a therapeutic intervention to reverse lipoatrophy, injection of soft-tissue fillers appears to be the simplest way to correct facial lipoatrophy. Many soft-tissue fillers, both biodegradable and permanent, have been studied in HIV facial lipoatrophy, however, long-term clinical safety and efficacy data are lacking. Biodegradable fillers have a good safety profile, but treatment with s...

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Section: Durabilitymentioning

confidence: 63%

Section: Other Soft-tissue Fillersmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Large particle hyaluronic acid for the treatment of facial lipoatrophy in HIV‐positive patients: 3‐year follow‐up study

Skeie¹,

Bugge

Negaard

et al. 2010

HIV Medicine

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“…The most frequently reported in the literature are Polylactic Acid, Polymethylmethacrylate, Hyaluronic Acid and Polyacrylamide, all of which have positively impacted the quality of life of patients [7,[35][36][37][38][39].…”

Section: Resultsmentioning

confidence: 99%

Characterisation of clinical epidemiological profile of patients with facial lipoatrophy, living with AIDS, submitted to facial filling with polymethylmethacrylate

Martins¹,

Martins²,

Pessôa³

et al. 2015

Int Arch Med

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Results:On average, HIV was diagnosed for 11.5 years, mean duration of antiretroviral therapy for 10 years and mean duration of 3.8 years for Facial Lipoatrophy. Most made use of Stavudine and/or Efavirenz. At the beginning of treatment, the mean dosage of CD4 was 284 cells/mm³ and at the time of filling the average was 709 cells/ mm³. Cholesterol levels were elevated in 44.4%, and the Triglycerides were elevated in 66.7%. There were practically no adverse effects from the filling.

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“…Each has specific advantages and disadvantages, as documented 8,15,[22][23][24][25][26][27] with satisfactory results.…”

Section: Figmentioning

confidence: 99%

Long-Term Efficacy and Safety of Polyacrylamide Hydrogel Injection in the Treatment of Human Immunodeficiency Virus–Related Facial Lipoatrophy

Pignatti

Baccarani

et al. 2012

Plastic and Reconstructive Surgery

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Hyaluronic Acid New Formulation: Experience in HIV-Associated Facial Lipoatrophy

Cited by 35 publications

References 49 publications

Large particle hyaluronic acid for the treatment of facial lipoatrophy in HIV‐positive patients: 3‐year follow‐up study

Large particle hyaluronic acid for the treatment of facial lipoatrophy in HIV‐positive patients: 3‐year follow‐up study

Characterisation of clinical epidemiological profile of patients with facial lipoatrophy, living with AIDS, submitted to facial filling with polymethylmethacrylate

Long-Term Efficacy and Safety of Polyacrylamide Hydrogel Injection in the Treatment of Human Immunodeficiency Virus–Related Facial Lipoatrophy

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