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Successful Treatment of Facial Lipoatrophy with a New Formulation of Hyaluronic Acid (Restylane SubQ)

Facial lipoatrophy (fat loss) is often a stigmatizing side effect of antiretroviral therapy, especially older agents such as stavudine (d4T, Zerit). Restylane SubQ, a new hyaluronic acid formulation, is a durable and well-tolerated dermal filler for treating facial lipoatrophy in people with HIV, according to a small 3-year study published in the September 24, 2009 online edition of HIV Medicine.

Norwegian researchers evaluated the safety and efficacy of a new large particle formulation of hyaluronic acid that can be injected in larger amounts and into deeper layers of the skin.

The study included 20 HIV patients who received injections of Restylane SubQ. Refill treatment was offered at 12 and 24 months. Treatment effects were evaluated using ultrasound, the Global Aesthetic Improvement Scale, visual analog scale (VAS), and the Rosenberg self-esteem scale. Response was defined as achieving total cutaneous (skin) thickness > 10 mm.

Results

At month 36, 17 patients remained in the study.
The response rate was 70%.
3 patients who received injections only at baseline still had higher total cutaneous thickness scores at 36 months.
15 patients classified their facial appearance as moderately or very much improved.
VAS scores increased significantly.
Treated patients reported higher self-esteem scores.
Local swelling and tenderness after treatment was common.
Persistent papules (small lumps) in several patients after treatment were effectively removed using hyaluronidase injections.

"Our results indicate that a large particle hyaluronic acid formulation is a durable and well-tolerated dermal filler for treating HIV-positive patients with facial lipoatrophy," the study authors concluded.

More Articles about Lipoatrophy Posted on HIV and Hepatitis.com

Departments of Infectious Diseases, Plastic Surgery, and Radiology, Oslo University Hospital, Oslo, Norway.

10/20/09

Reference
L Skeie, H Bugge, A Negaard, and BM Bergersen. Large particle hyaluronic acid for the treatment of facial lipoatrophy in HIV-positive patients: 3-year follow-up study. HIV Medicine. Published online September 24, 2009. (Abstract).