7th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 13–16 November 2005, Dublin, Ireland

EFFECTIVENESS AND DURABILITY OF POLYACRYLAMIDE HYDROGEL INJECTIONS FOR TREATING HIV-RELATED FACIAL LIPOATROPHY

G Orlando¹, G Guaraldi¹, A Pedone¹, A Spaggiari¹, A Baccarani¹, V Borghi¹, G Nardini¹, B Beghetto¹, C Cappi¹ and G De Santis^1
1 University of Modena and Reggio Emilia, Modena, Italy

Antiviral Therapy 2005; Supplement 3:L29 (abstract no. 44)

OBJECTIVES: Polyacrylamide hydrogel injection implant (PHI) is a stable, pH neutral, insoluble, non-toxic injectable implant used for facial and body contour correction and reconstruction. The aim of our study was to assess objective and subjective effectiveness and durability of PHI in HIV-infected individuals with facial lipoatrophy.

METHODS: Prospective observational study. Patients who completed 52 weeks follow up since last injection were analysed. Durability of PHI was evaluated by ultrasonography of the cheek thickness (CT). Analysis of aesthetic facial satisfaction was assessed with visual analogue scale (VAS), evaluation of body image satisfaction (BIS) and psychological consequences (PC) of lipodystrophy was investigated with the ACTG Assessment of Body Change and Distress questionnaire (ABCD) and depression with Beck depression scale.

RESULTS: In a cohort of 189 HIV-infected patients undergoing PHI, 41 were included in the analysis. Patients’ baseline characteristics were: 83.7% male, mean age 44 ±7 years, CD4 at surgery 537 ±300 cells/ml, median HIV-VL at surgery 2.5 ±1 log copies/ml, mean HAART exposure 65 ±22 months, mean d4T exposure 47 ±23 months. Ultrasound evaluation showed an increase in CT: right CT= +2.72 ±3.1, P<0.0001; left CT= +2.54 ±3.29, P<0.0001. VAS (VAS 46.53 ±28.15 P<0.0001) and Beck depression score improved (Beck 2.87 ±6.19 P=0.007). On the ABCD, body image satisfaction increased (BIS –0.72 ±1.115 P<0.0001), and psycho-social impact decreased (PC 7.87 ±15.72 P=0.007). There were no serious adverse events; no patients developed skin nodules.

CONCLUSIONS: Physical and psychological benefits of PHI were sustained over at least 12 months. There were no serious immediate or delayed adverse events.

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2005-11-13
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