Hyaluronic acid treatment of facial fat atrophy in HIV‐positive patients

Bugge, Helge Fagerheim; Negaard, Anne; Skeie, Linda Gail; Bergersen, Bente Magny

doi:10.1111/j.1468-1293.2007.00494.x

Cited by 30 publications

(49 citation statements)

References 27 publications

(34 reference statements)

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“…Twelve-month treatment results from this study have been reported earlier [14]. In the present study, we report longerterm efficacy, safety and durability data. …”

supporting

confidence: 79%

“…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.…”

mentioning

confidence: 99%

“…Safety assessments included physical examination and recording of directly observed and spontaneously reported adverse events. Assessments performed at 12 months have been published previously in the 52-week follow-up study report [14]. …”

mentioning

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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“…Twelve-month treatment results from this study have been reported earlier [14]. In the present study, we report longerterm efficacy, safety and durability data. …”

supporting

confidence: 79%

mentioning

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

Self Cite

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“…Amongst the patients, 11% reported facial lipoatrophy, while the doctors observed clinically detectable facial lipoatrophy in 15% of the patients. 37 …”

Section: Epidemiologymentioning

confidence: 99%

Lipoatrofia facial associada ao HIV/AIDS: do advento aosconhecimentos atuais

Soares¹,

Costa

2011

An. Bras. Dermatol.

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Abstract:The advent of AIDS has brought new challenges to Dermatology. Antiretroviral therapy dramatically changed the morbidity and mortality associated with HIV / AIDS, but contributed to the emergence of other new situations that require adequate approach by the dermatologist. The HIV / AIDS Associated Lipodystrophy Syndrome is multifactorial in origin, but it is strongly associated with the use of antiretroviral drugs. It includes changes in body fat distribution, with or without metabolic changes. The loss of facial fat, called facial lipoatrophy, is one of the most stigmatizing signs of the syndrome. This condition, often revealing of the disease, brought back the stigma of AIDS. It is necessary that the specialists working with patients with HIV / AIDS identify these changes and seek treatment options, amongst which stands out the implant with polymethylmethacrylate, which is available for the treatment of HIV / AIDS facial lipoatrophy in the Brazilian Public Health System. Keywords: Ambulatory surgical procedures; HIV; HIV-associated lipodystrophy syndrome; Polymethyl methacrylate; Therapeutics Resumo: O advento da AIDS trouxe novos desafios para a Dermatologia. A terapia antirretroviral mudou drasticamente a morbimortalidade associada à infecção pelo HIV/AIDS, mas contribuiu para o surgimento de outras novas situações que exigem abordagem adequada do dermatologista. A Síndrome Lipodistrófica Associada ao HIV/AIDS tem origem multifatorial, mas está fortemente associada ao uso dos antirretrovirais. Compreende alterações na distribuição da gordura corporal, acompanhada ou não de alterações metabólicas. A perda da gordura da face, chamada lipoatrofia facial, é dos sinais mais estigmatizantes da síndrome. Esta condição, muitas vezes reveladora da doença, trouxe de volta o estigma da AIDS. É necessário que os especialistas que atuam com pacientes com HIV/AIDS identifiquem estas alterações e busquem opções de tratamento, dentre as quais se destaca o implante com polimetilmetacrilato, que é disponibilizado para tratamento da lipoatrofia facial associada ao HIV/AIDS no Sistema Único de Saúde.

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“…Le Perlane® (Q-Med, Uppsala, Suède) en contient 10 000/ml. Le Restylane Sub-Q® est un NASHA plus visqueux, plus épais et moins résorbable ; il contient 1000 particules de gel/ml [11,12]. Bien que l'AH et en particulier les NASHA soient théori-quement non-toxiques, plusieurs effets indésirables ont été rapportés [13][14][15][16].…”

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Complication après injection d’acide hyaluronique : présentation d’un cas

d’Elbée¹,

Fricain²

2013

Med Buccale Chir Buccale

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Résumé -Les produits de comblement à base d'acide hyaluronique (AH) constituent une référence dans la correction et l'augmentation de volume des tissus mous faciaux. Ils ont une longue durée d'action, sont peu immunogènes et peuvent être éliminés par injection locale de hyaluronidase. Ces avantages expliquent leur utilisation fréquente. Des complications aiguës ou chroniques, mineures ou sévères, peuvent survenir après leur injection, même réalisée par un praticien expérimenté. Le cas d'une patiente ayant souffert de complications infectieuses et inflammatoires chroniques après injection d'acide hyaluronique est rapporté. Abstract -Complication following the injection of hyaluronic acid: a case report. Hyaluronic acid (HA) fillershave become the material of choice for soft-tissue augmentation of the face. They are longer lasting, less immunogenic and can be broken down by hyaluronidase. These advantages make HA fillers the most common of the temporary fillers on the market. However, early and delayed complications, ranging from minor to severe, can occur following HA-filler injection even if administered by an experienced practictioner. The case of a patient who suffered from chronic infectious and inflammatory complications following the injection of hyaluronic acid is reported.

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Hyaluronic acid treatment of facial fat atrophy in HIV‐positive patients

Cited by 30 publications

References 27 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

Lipoatrofia facial associada ao HIV/AIDS: do advento aosconhecimentos atuais

Complication après injection d’acide hyaluronique : présentation d’un cas

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