Diapositiva 1

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EFFECTIVENESS AND DURABILITY OF POLYACRYLAMIDE
HYDROGEL INJECTIONS FOR TREATING HIV-RELATED
FACIAL LIPOATROPHY
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• G Orlando, G Guaraldi, A Pedone, A Spaggiari, A
  Baccarani, V Borghi, G Nardini, B Beghetto, C
  Cappi, G De Santis
• Metabolic Clinic, University of Modena and
  Reggio Emilia, Italy

1. Background and aims
4. Total cheeks thickness
5. Pictures comparison
Polyacrylamide hydrogel is an atoxic, stable,
non-reabsorbable sterile watery gel for injection
into soft tissues. It consists of 2.5
crosslinked polyacrylamide and non-pyrogenic
water and is supplied in a disposable 1 ml
syringe with a 27 g sterile needle that is used
to inject into the subcutaneous space every 4
weeks. The mechanism of action is the volume
augmentation of the subcutaneous area equal to
the amount injected (11)

• Right CT 2.723.1,
• p

• Left CT 2.543.29,
• p

• INCLUSION CRITERIA
• Documented HIV infection
• LD diagnosis with facial wasting
• Age18 years
• Being on HAART for at least 6 months

• EXCLUSION CRITERIA
• CD4
• Hemorrhagic disease
• Thrombcytopenia (
• Surgeons opinions of no aesthetic benefit
• Unwillingness to be followed up for 12 months

Pictures are pubblished with pts permission
6.Beck Depression Index
8. Body image, ABCD
2. Methods
Psychological and social distress ? PC
7.8715.72, p .007
Body Image satisfaction ? BIS -0.721.11, p

? Beck 2.876.19, p .007
Objective efficacy and durability ultrasound
evaluation of cheek thickness (CT) was used to
assess durability of the result Subjective
effectiveness A 0 to 10 Visual analogue scale was
used to assess satisfaction with face aesthetic
results Beck Depression Inventory questionnaire,
to define improvement of depression scores The
ACTG-ABCD questionnaire (Assessment of Body
Change and Distress), with its subscales body
image satisfaction, BIS and psychological
consequences, PC, to assess the effect of
treatment on body image perception
3. Results, baseline characteristics
7. Aesthetic satisfaction of the face
9. Discussion
In a cohort of 189 patients undergoing PHI, 41
(83.7 male) completed 52 weeks follow up since
last injection and has been included in the
analysis
Polyacrylamide hydrogel injections for the
tratment of HIV-related face lipoatrophy 52 weeks
after the last injections resulted in a
statistically significant Increase of both
cheeks thickness Increase of aesthetic
satisfaction of the face Decrease of depression
score Improvement of body image
satisfaction Decrease of the psycho-social impact
of face lipoatrophy Physical and psychological
benefit of PHI were sustained over at least 12
months No serious immediate or delayed adverse
event occurred
? VAS 46.5328.15, p
Mean SD Age, yrs 44,44 7,288 Injections,
no. 5,55 2,634 HIV since, yrs 12,95 4,662 HAART,
months 64,91 22,842 D4T, months 46,92 23,565 NRTIs
, months 102,28 42,361 NNRTIs, months 19,65 15,109
PIs, months 38,14 28,815 Nadir
CD4 175,76 156,333 CD4 baseline,
537,93 300,511 VL baseline, log 2,5215 1,02805
Mean SD Weight,kg 65,41 7,182 Waist,
cm 82,24 6,448 Hip, cm 88,946 3,5469 WHR 1,3
819 2,77498 BMI 21,720 4,1970 Glucose,
mg/dL 94,49 22,937 Total CH, mg/dL 201,83
52,110 HDL 46,04 26,191 LDL 112,00 38,900 T
ryglicerides 279,27 197,560 Right cheek
thickness, mm 4,0339 1,73548 Left cheek
thickness, mm 4,2306 2,06085
Author mail g.guaraldi_at_unimo.it