Treatment of facial lipoatrophy with polymethylmethacrylate among patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS): impact on the quality of life

Quintas, Rodrigo Campos Soares; França, Emmanuel Rodrigues de; Petribú, Kátia; Ximenes, Ricardo A. A.; Quintas, Lóren F. F. M.; Cavalcanti, Ernando Luiz Ferraz; Kitamura, M; Magalhães, Kássia A. A.; Paiva, Késsia C. F.; Filho, Demócrito B Miranda

doi:10.1111/ijd.12400

Cited by 11 publications

(11 citation statements)

References 26 publications

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“…Atrophic changes consist of subcutaneous fat atrophy in the legs, buttocks, arms, and nasolabial and malar fat pads. The cosmetically disfiguring changes that occur with lipodystrophy may have a significant impact on quality of life and relational activities [14] . Dyslipidemia was reported in HIV-infected individuals regardless of drug therapy [15] .…”

Section: Hiv and Lipodystrophymentioning

confidence: 99%

Lipodystrophy HIV-related and FGF21: A new marker to follow the progression of lipodystrophy?

Benedini

Luzi

2016

Journal of Translational Internal Medicine

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Recently new evidence about fibroblast growth factor 21 (FGF21) highlights the opportunities to use this molecule in new pharmaceutical formulations to combat type 2 diabetes and metabolic syndrome. It is well known that HIV is per se a condition of insulin resistance and in particular the patient with HIV-related lipodystrophy has a condition strictly related to metabolic syndrome. Lipodystrophy is associated with severe metabolic side effects, including dyslipidemia, hepatic insulin resistance, and lipid oxidation impairment. Research carried out showed that FGF21 levels were significantly increased in untreated HIV-1-infected patients and the increase was much marked in HIV-1-infected antiretroviral-treated patients that have developed lipodystrophy and in the patients with greatest metabolic alterations. FGF21 is expressed mainly by the liver, but also by other tissues such as the thymus, adipose tissue, and skeletal muscle. Therefore, many researchers have considered the investigation of possible variations of FGF21 in patients with significant alterations in body composition both in regard to fat mass and lean mass. In the light of the possible interactions between FGF21 and metabolic syndrome, it seems interesting to evaluate the implication of this hormone in patients with HIV-related lipodystrophy who have a severe metabolic picture of insulin resistance with important alterations in body composition.

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Section: Hiv and Lipodystrophymentioning

confidence: 99%

Lipodystrophy HIV-related and FGF21: A new marker to follow the progression of lipodystrophy?

Benedini

Luzi

2016

Journal of Translational Internal Medicine

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“…Polymethylmethacrylate is used in a synthetic permanent filler composed of microspheres of PMMA in a 3.5% collagen solution. We identified four observational studies assessing the efficacy of PMMA in the treatment of HIV FLA. Two studies assessed QoL outcomes …”

Section: Resultsmentioning

confidence: 99%

“…(2011) and Quintas et al . (2014) reported significant improvement in QoL in patients treated with PMMA, assessed by the SF‐36 and the HAT‐QoL and SF‐36, respectively. Warde et al .…”

Section: Resultsmentioning

confidence: 99%

“…36 Additionally, outcomes in eight of nine domains on the HAT-QoL were significantly improved after treatment, with only that in the overall function domain not reaching statistical significance. 36…”

Section: Polymethylmethacrylatementioning

confidence: 90%

“…We identified four observational studies assessing the efficacy of PMMA in the treatment of HIV FLA. Two studies assessed QoL outcomes. 35,36 Warde et al (2011) 35 health status, vitality, social aspects, emotional aspects, and mental health). 35 Quintas et al included 60 patients (51 completed the research) and found significant improvements in six of the eight domains of the SF-36 (median scores for functional capacity and pain did not change from baseline) at 3 months post-treatment.…”

Section: Polymethylmethacrylatementioning

confidence: 99%

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Quality of life outcomes associated with treatment of human immunodeficiency virus (HIV) facial lipoatrophy

et al. 2016

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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.

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A systematic review of filler agents for aesthetic treatment of HIV facial lipoatrophy (FLA)

Jagdeo

Ho²,

et al. 2015

Journal of the American Academy of Dermatology

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HIV facial lipoatrophy (FLA) is characterized by facial volume loss. HIV FLA affects the facial contours of the cheeks, temples, and orbits, and is associated with social stigma. Although new highly active antiretroviral therapy medications are associated with less severe FLA, the prevalence of HIV FLA among treated individuals exceeds 50%. The goal of our systematic review is to examine published clinical studies involving the use of filler agents for aesthetic treatment of HIV FLA and to provide evidence-based recommendations based on published efficacy and safety data. A systematic review of the published literature was performed on July 1, 2015, on filler agents for aesthetic treatment of HIV FLA. Based on published studies, poly-L-lactic acid is the only filler agent with grade of recommendation: B. Other reviewed filler agents received grade of recommendation: C or D. Poly-L-lactic acid may be best for treatment over temples and cheeks, whereas calcium hydroxylapatite, with a Food and Drug Administration indication of subdermal implantation, may be best used deeply over bone for focal enhancement. Additional long-term randomized controlled trials are necessary to elucidate the advantages and disadvantages of fillers that have different biophysical properties, in conjunction with cost-effectiveness analysis, for treatment of HIV FLA.

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Treatment of facial lipoatrophy with polymethylmethacrylate among patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS): impact on the quality of life

Abstract: The treatment of facial lipoatrophy improved the self-perceived quality of life and facial image as well as any depressive symptoms among patients with HIV/AIDS.

Cited by 11 publications

References 26 publications

Lipodystrophy HIV-related and FGF21: A new marker to follow the progression of lipodystrophy?

Lipodystrophy HIV-related and FGF21: A new marker to follow the progression of lipodystrophy?

Quality of life outcomes associated with treatment of human immunodeficiency virus (HIV) facial lipoatrophy

A systematic review of filler agents for aesthetic treatment of HIV facial lipoatrophy (FLA)

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