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Hyaluronic acid filler effective at treating HIV-associated facial lipoatrophy

Patients with HIV-associated facial lipoatrophy who received treatment with hyaluronic acid filler achieved significant improvement in facial volume up to 1 year, with no permanent adverse events, according to study results published in JAMA Dermatology.

Researchers conducted an open-label study of 20 men (mean age, 57 years) with HIV-associated facial lipoatrophy (FLA) who received one hyaluronic acid treatment with an optional touch-up at the Sacramento Veterans Medical Center, Mather, California. The patients had a Carruthers Lipoatrophy Severity Scale (CLSS) grade of 2 or greater and had not been previously treated for FLA during the prior year.

Treatment and follow-up occurred between March 15, 2015, and May 17, 2016.

Treatment included midface (cheeks and temples) volumization using the “smile and fill,” fanning and depot technique, followed by an optional touch-up at 2-week follow-up. Patients Nineteen patients completed the study, and the mean volume of hyaluronic acid used in initial treatments were 4.5 mL for grade 2 FLA, 8 mL for grade 3 FLA and 18 mL for grade 4 FLA, with 1 mL equaling 1 syringe of hyaluronic acid filler. Fourteen patients received touch-up treatments.

Mean total volume of hyaluronic acid used for all treatments was 6.1 mL for grade 2 FLA, 9.3 mL for grade 3 FLA and 26 mL for grade 4 FLA.

There were no reports of permanent treatment-related adverse events, with common transient adverse events lasting less than 21 days including ecchymosis, edema, tenderness and pain.

The patients achieved a significant decrease in CLSS, with all patients achieving CLSS grade 1 after optional touchup at 2-week follow-up visit. All patients maintained CLSS grade 1 at follow-ups.

All patients were rated much improved using the Global Aesthetic Improvement Scale at 2-week follow-up, with patients rated at very much improved at 12 months.

“This study reports excellent safety and efficacy and supports use of this [hyaluronic acid] filler for treatment of HIV FLA, with durable results at 12 months,” the researchers concluded. “Future multicenter, randomized clinical trials with blinded independent investigators may confirm its long-term safety, efficacy and durability. Additional research may ensure widespread adoption by dermatologists and patients.” – by Bruce Thiel

Disclosure: Ho reports no relevant financial disclosures. Please see the full study for the other researcher’s relevant financial disclosures.