Facial fat loss on HAART may be cosmetically improved with injections of a substance called polylactic acid, according to French researchers who tested the treatment in 33 HIV-positive men in Paris and Lyons. The findings were presented at the Second International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV, held in Toronto between September 13th and 15th.
Polylactic acid is a preparation already used in cosmetic surgery as treatment for fine lines, wrinkles and furrows. It differs from silicon and collagen implants in that it isn’t immunologically active (thus avoiding any prospect of allergic or inflammatory response) and it is absorbed and broken down, unlike silicon implants. French researchers decided to test its usefulness in relieving the facial fat wasting that has been seen in people with HIV, and associated in some studies with long-term d4T treatment.
Thirty-three patients who had been taking HAART for an average of 64 months were treated with an average of 4 injections below the surface of the skin over a six month period. Twenty four had severe fat loss (defined as a thickness of less than one millimetre on the cheeks).
All the patients had some degree of improvement, but the facial fat compartment was not significantly restored. Polylactic acid works by stimulating collagen growth and the development of a thicker layer of skin which fills out the wasted regions of the cheeks, and the thickened dermal layer remains after the polylactic acid has been broken down and dispersed.
After 6 months the dermal thickness had increased by an average of 153%, from an average of 3.1 mm to 8.15mm, a highly significant improvement. Seven patients had experienced a restoration to normal facial appearance by the third injection, and a further six experienced maximum improvement by the fifth injection.
Amard P et al. The effects of polylactic acid (New-Fill) as therapy for lipoatrophy of the face. Antiviral Therapy 5(Supp 5): abstract P94, 2000.