Hyaluronic acid new formulation: experience in HIV-associated facial lipoatrophy

Facial lipoatrophy (FLA) is a stigmatizing complication of antiretroviral therapy in patients with human immunodeficiency virus (HIV) infection.

To evaluate the efficacy and safety of facial volume restoration in patients with HIV-associated FLA, using a novel long-lasting, hyaluronic acid high-density formulation.

Twenty-one males with FLA were enrolled in this prospective, open-label, monocenter pilot study. Each patient received subcutaneous implantation of high-density hyaluronic acid. The aesthetic outcome was evaluated using the Global Aesthetic Improvement Scale every 3 months until 12 months after implantation. Additionally, patient satisfaction was analyzed, changes in patient quality of life were recorded using the Dermatology Life Quality Index (DLQI), and side effects were documented.

Nineteen patients (n = 19; 90.5%) were much improved or better 3 months after implantation, while 2 patients (n = 2; 9.5%) were improved and received a touch-up. Twelve months after implantation, still 16 patients (n = 16; 76.2%) were much improved or better, and 4 patients (n = 4; 19%) were improved. Patient satisfaction was high at every evaluation point over 12 months. The median DLQI before treatment was 16 (range: 13-19). Twelve months after augmentation, a significant decrease in the DLQI was observed (median: 9; range: 6-14) resulting in a relative reduction and significant improvement of the DLQI of 43.75% (p < 0.05), respectively. Side effects were mild and temporary (ecchymosis, edema and erythema).

We propose the use of this new formulated hyaluronic acid for HIV-associated FLA as an efficacious and safe therapeutic option causing immediate augmentation of the soft tissues. The implant showed sustained longevity of 12 months and resulted in significant aesthetic improvement. It is notable for its simple and safe method of implantation and results in high patient satisfaction.