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Safety and efficacy of poly-L-lactic acid injections in persons with HIV-associated lipoatrophy: the US experience
1Blue Pacific Aesthetic Medical Group, El Segundo, California 90245, USA. drmest@aol.com
Insights
Poly-L-lactic acid (PLLA) injections effectively treat facial wasting in HIV patients, showing significant skin thickness improvement and high patient satisfaction. This safe and durable treatment option offers long-term correction for HIV-associated lipodystrophy.
Area of Science:
- Dermatology
- Infectious Diseases
- Plastic Surgery
Background:
- Highly active antiretroviral therapy (HAART) has increased HIV/AIDS survival, leading to chronic conditions like HIV-associated lipodystrophy.
- Facial wasting (lipoatrophy) is a common morphologic change associated with HIV-associated lipodystrophy.
Purpose of the Study:
- To assess the effectiveness of poly-L-lactic acid (PLLA) in correcting facial lipoatrophy.
- To evaluate the long-term safety and durability of PLLA for treating HIV-associated lipodystrophy.
Main Methods:
- An open-label, single-site study involving serial PLLA injections.
- Patients received up to six treatment sessions and were followed for 12 months post-treatment.
- Evaluations included skin caliper measurements, serial photography, and patient-reported outcomes.
Main Results:
- Mean skin thickness increased by 65.1% at the end of treatment, with sustained improvement at 12 months (73%).
- Patient satisfaction scores were high (4.5, increasing to 4.8 at 12 months).
- No serious adverse events were reported during the study.
Conclusions:
- Poly-L-lactic acid (PLLA) is a safe and well-tolerated treatment for HIV-associated lipoatrophy.
- PLLA provides quantifiable and durable improvement in facial wasting.
- The treatment enhances patient satisfaction and well-being.
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.
