3rd International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 23-26 October 2001, Athens, Greece

SUCCESSFUL SURGICAL THERAPY WITH POLYVINYL GEL MICRO SPHERES OF SEVERE FACIAL LIPOATROPHY: RESULTS AFTER 1 YEAR OF FOLLOW-UP

Antiviral Therapy 2001; 6(Suppl. 4):36 (abstract no. 50)

V Del Pino¹, JM Arevalo¹, S Moreno² and F Dronda^2
1 Centrode Cirugia Estetica Serrano 76, Madrid, Spain; and ² Ramony Cajal Hospital, Madrid, Spain

BACKGROUND: Highly active antiretroviral therapy may be associated with changes in body shape. The lipodystrophy syndrome combines different clinical manifestations. Atrophy in the face can be especially worrisome. No effective therapeutic measures have been developed until now.

METHODS: Prospective study of all HIV-infected patients who developed severe facial atrophy and were treated with injections of polyacrylamide/polyvinyl gel microspheres (Evolution). Small volumes of the product (mean±SD: 8.6±7 mm³) were injected, after administration of local anesthesia. Clinical pictures were taken before and after the surgical procedure. A previous photograph of the patient was used as comparison. Each subject completed a structured questionnaire for evaluating ongoing results after the third control (month 6).

RESULTS: Between October 1999 and December 2000, 35 patients were evaluated. There were 23 men and median age was 41 years (range 34-67). Most patients (n=29) were HIV-infected through unsafe sexual risk practices. All patients had received protease inhibitor-containing regimens for a mean time (±SD)of 2.5 (±1.8) years. Faciallipoatrophy was developed for a mean time (±SD) of 9.3 (±6.1) months before surgery. Most patients (66%) completed therapy with only two surgical sessions. Self-reported outcome was excellent or very good in 33 patients (94.3%), after 1 year of follow-up. Only two patients (5.7%) developed mild local complications (transient periorbital edema). Comparative clinical pictures will be presented.

CONCLUSION: A simple refill method with an acrylic substance can be a safe therapeutic procedure for atrophy of the face. Self-reported results from the patients were excellent after 1 year of follow-up.

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