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Safety and Efficacy of Poly-L-lactic Acid Injections in Persons with HIV-Associated Lipoatrophy: The US Experience

MEST, DOUGLAS, R., MD*; HUMBLE, GAIL, MD*

ORIGINAL ARTICLE
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BACKGROUND With the introduction of highly active antiretroviral therapy (HAART), HIV/AIDS has become a more chronic disease. This increase in survival, however, has been accompanied by the occurrence of metabolic and morphologic changes known collectively as HIV-associated lipodystrophy.

OBJECTIVE The objective was to evaluate the quantifiable improvement in facial wasting (lipoatrophy) after serial injections of poly-L-lactic acid (PLLA) as well as the long-term safety and durability of this material.

METHODS AND MATERIALS A single-site, open-label study in which patients received up to six treatment sessions of injectable PLLA. Patients were followed for 12 months after treatment. Patients were evaluated for increase in total cutaneous thickness by skin calipers. Serial photographs and patient satisfaction and patient well-being questionnaires were undertaken throughout the study period.

RESULTS Patients at the end of treatment exhibited a mean increase in skin thickness of 65.1% compared with baseline values. This correction was maintained throughout the 12-month follow-up period (68.8% at 6 months and 73% at 12 months). On a one to five scale, patient satisfaction was 4.5 at the end of treatment and increased to 4.8 at 12-month follow-up. No serious adverse events were reported.

CONCLUSION PLLA is a safe and well-tolerated treatment option for HIV-associated lipoatrophy.

*Both authors are affiliated with the Blue Pacific Aesthetic Medical Group, El Segundo, California

Address correspondence and reprint requests to: Douglas Mest, MD, Clinical Director, Blue Pacific Aesthetic Medical Group, 2301 Rosecrans Avenue, #1135, El Segundo, CA 90245, or e-mail: drmest@aol.com.

© 2006 by the American Society for Dermatologic Surgery, Inc.
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