Poly‐l‐lactic acid for HIV‐1 facial lipoatrophy: 48‐week follow‐up

Objectives Poly‐l‐lactic acid (PLA) injections modestly increase objectively assessed facial thickness but not facial soft tissue volume (FSTV) over 24 weeks. The durability of this response has not been well defined objectively. Methods HIV‐infected lipoatrophic adults were randomized to four open‐...

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Bibliographic Details
Published in:HIV medicine 2009-03, Vol.10 (3), p.163-172
Main Authors: Carey, D, Baker, D, Petoumenos, K, Chuah, J, Rogers, GD, Watson, J, Cooper, DA, Emery, S, Carr, A
Format: Article
Language:English
Subjects:
Adult
Cosmetic Techniques
Face
Female
Follow-Up Studies
HIV
HIV-1
HIV-Associated Lipodystrophy Syndrome - drug therapy
HIV-Associated Lipodystrophy Syndrome - psychology
Human immunodeficiency virus 1
Humans
Injections, Subcutaneous
Lactic Acid - administration & dosage
lipoatrophy
Male
Polyesters
Polymers - administration & dosage
poly‐l‐lactic acid
Quality of Life - psychology
Severity of Illness Index
Time Factors
Treatment Outcome
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Summary:Objectives Poly‐l‐lactic acid (PLA) injections modestly increase objectively assessed facial thickness but not facial soft tissue volume (FSTV) over 24 weeks. The durability of this response has not been well defined objectively. Methods HIV‐infected lipoatrophic adults were randomized to four open‐label PLA treatments administered every 2 weeks from week 0 (immediate group, n=50) or from week 24 (deferred group, n=50). Endpoints included FSTV assessed by computed tomography, facial lipoatrophy severity, quality of life (QoL) and safety. Analyses were by intention to treat. Results Between weeks 24 and 48, soft tissue thickness increased modestly in injection planes, at the maxillary [mean 0.9 mm; 95% confidence interval (CI) 0.3–1.5 mm; P=0.007] and base of nasal septum levels (mean 0.4 mm; 95% CI 0.1–0.8; P=0.021), but not in untreated areas (P=0.79 and P=0.24). PLA durability assessed at week 48 in immediate group participants showed a mean change in FSTV of 14 cm3 (95% CI−1 to 29 cm3; P=0.060) and increased tissue depth at the maxillary (P
ISSN:1464-2662
1468-1293
DOI:10.1111/j.1468-1293.2008.00667.x