Abstract

E-mail Abstract Author Add To Itinerary Session Search Abstracts Program

Session 92 Poster Session Switch Studies/Treatment of Lipodystrophy Syndromes Session Time: 4:30-6:30 pm Room 4E-F

704-T. Treatment of HIV-Associated Lipoatrophy of the Face with Intradermal Injections of Polylactic Acid M. Lafaurie*, J. Dolivo, D. Boulu, I. Madelaine, and J. M. Molina St. Louis Hosp., Paris, France Background: Surgery for treatment of fat lipoatrophy of the face associated with antiretroviral therapy is not a convenient procedure. The main objective of this work was to evaluate the safety and efficacy of intradermal injections of polylactic acid, a biodegradable component, in the treatment of lipoatrophy of the face. Methods: Patients were injected with polylactic acid in the derm of both cheeks and in temporal zones if necessary. To be eligible for this treatment, patients should have a sustained control of their HIV infection (CD4 count > 300/mm3 and viral load < 5000 copies/mL for at least 3 months). Patients with skin disease or infection of the face or experiencing fever could not receive the injections. Injections of polylactic acid mixed with xylocaďne were done every 15 days. Efficacy of the treatment was assessed by the patients through a standardized questionnaire evaluating quality of life (QOL) and an analogic visual scale satisfaction index (AVSI) at each injection session. Tri-dimentional photographs of the face were also done 2 days before and after each session. These photographs were analyzed by a software calculating surface and volume gains at the site of injections. Results: 16 patients (14 males, 2 females, mean age 46 years) were treated. All patients were under HAART. Mean CD4 count was 500/mm3. Mean injected volume of polylactic acid was 2.5 mL per cheek and per injection. 7 patients completed the treatment, receiving between 4 and 5 injections. Mean AVSI before the first injection was 1/10 and increased to 8/10 after 3 injections. Results of serial QOL showed a trend towards a better quality of life. Mean surface gain was 0.4 mm2 and 0.3 mm2 and mean volume gain was 15 mm3 and 13 mm3 for the right and left parts of the face respectively. No serious complication, no bacterial infection were reported. 2 patients experienced a malaise after the first injection. Grade 1 pain was present in 5% of patients. Conclusion:Intradermal injection of polylactic acid is a safe, convenient, and effective treatment for facial lipoatrophy in patients infected with HIV.

©2002 9th Conference on Retroviruses and Opportunistic Infections