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Complications Following Non-Surgical Aesthetic Treatments in HIV+ Patients Receiving Antiretroviral Therapy: A 12-Years Experience. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11094059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Since the advent of HIV antiretroviral therapies at the end of the 20th century, the morbidity and mortality rates associated with HIV infection have decreased dramatically. Unfortunately, these benefits are associated with substantial morphologic changes in the body, such as abnormal fat distribution with peripheral lipohypertrophy and facial lipoatrophy. Facial wasting is considered the major stigma for HIV–infected people and may result in reduced antiretroviral adherence. Patients suffering from the stigmata of HIV infection can benefit from non-surgical aesthetic treatments performed with fillers or lipolytic agents that provide a quick and reliable service for facial rejuvenation, with high patient satisfaction and a low risk of complications. In the present paper, a retrospective analysis of complications following non-surgical aesthetic treatments (calcium hydroxyapatite-based filler, hyaluronic acid filler, polyacrylamide hydrogel filler and dehoxycholic acid injections), in a cohort of 116 consecutive HIV+ patients, treated over a period of 12 years, was performed. With the exception of the tardive swelling reported after calcium hydroxyapatite injections, complications were recorded just after polyacrylamide hydrogel treatment as small, palpable, nonvisible nodules or aseptic abscess. Our experience is consistent with those already published in the literature and the complication rate seems to be comparable to non-infected patients.
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Rauso R, Albani G, Salini C, Rugge L, Chirico F, Tartaro G. Continuum: Late Onset Complications Secondary to Polyacrylamide Hydrogel-Based Filler for Rehabilitation of HIV-Related Facial Lipoatropy. Aesthet Surg J 2019; 39:NP152-NP155. [PMID: 30802905 DOI: 10.1093/asj/sjz030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Raffaele Rauso
- Professor of Maxillofacial Surgery, University of Campania “Luigi Vanvitelli,” Naples, Italy
| | - Giada Albani
- Residents in Maxillofacial Surgery, Federico II University, Naples, Italy
| | - Chiara Salini
- Residents in Maxillofacial Surgery, Federico II University, Naples, Italy
| | - Luigi Rugge
- Residents in Maxillofacial Surgery, Federico II University, Naples, Italy
| | - Fabrizio Chirico
- Residents in Maxillofacial Surgery, Federico II University, Naples, Italy
| | - Gianpaolo Tartaro
- Head of the Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli,” Naples, Italy
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Rauso R, Califano L, Rugge L, Chirico F, Tartaro G. Late Onset Complications Secondary to Polyacrylamide Hydrogel-Based Filler for Rehabilitation of HIV-Related Facial Lipoatropy. Aesthet Surg J 2018; 38:NP170-NP174. [PMID: 30321286 DOI: 10.1093/asj/sjy226] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Rauso R. 5-year study of a polyacrylamide hydrogel-based filler for rehabilitation of HIV-related facial lipoatrophy. Aesthet Surg J 2015; 35:1021-9. [PMID: 25953480 DOI: 10.1093/asj/sjv036] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/02/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lipoatrophy of the face negatively impacts the quality of life and body image of individuals on antiretroviral therapy. Facial fillers can minimize the stigma associated with the human immonodeficiency virus (HIV). OBJECTIVES In this 5-year follow-up study, the author assessed the safety and efficacy of a permanent, non-biodegradable, polyacrylamide hydrogel for facial volume restoration, and compared the results with those of a previous 18-month follow-up study. METHODS Thirty-one HIV-positive individuals, initially enrolled in the study between January 2008 and January 2009, received treatment of facial wasting by injection of the polyacrylamide gel until complete volume restoration was achieved. Asepsis rules were strictly observed before and during each injection session. Patients evaluated their aesthetic outcomes on a visual analog scale. RESULTS Patient satisfaction was high. There was no occurrence of local infection, foreign-body reaction, or product during the 5 years of follow-up. Small, palpable, nonvisible nodules were recorded in nine cases. It appears that these same nodules were present in the 18-month study. It is believed that the nodules were caused by overfilling in the same site. CONCLUSIONS As supported by the initial 18-month study, polyacrylamide hydrogel filler appears safe and effective for the treatment of HIV-related lipoatrophy. With strict observation of asepsis rules and patient adherence to posttreatment instructions, this filler can be ideal for treating facial wasting in patients with HIV. LEVEL OF EVIDENCE 3 Therapeutic.
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Affiliation(s)
- Raffaele Rauso
- Dr Rauso is an Assistant Professor in the Department of Dentistry at the University of Foggia, Foggia, Italy
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Jagdeo J, Ho D, Lo A, Carruthers A. A systematic review of filler agents for aesthetic treatment of HIV facial lipoatrophy (FLA). J Am Acad Dermatol 2015; 73:1040-54.e14. [PMID: 26481056 DOI: 10.1016/j.jaad.2015.08.040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 08/17/2015] [Accepted: 08/19/2015] [Indexed: 01/07/2023]
Abstract
HIV facial lipoatrophy (FLA) is characterized by facial volume loss. HIV FLA affects the facial contours of the cheeks, temples, and orbits, and is associated with social stigma. Although new highly active antiretroviral therapy medications are associated with less severe FLA, the prevalence of HIV FLA among treated individuals exceeds 50%. The goal of our systematic review is to examine published clinical studies involving the use of filler agents for aesthetic treatment of HIV FLA and to provide evidence-based recommendations based on published efficacy and safety data. A systematic review of the published literature was performed on July 1, 2015, on filler agents for aesthetic treatment of HIV FLA. Based on published studies, poly-L-lactic acid is the only filler agent with grade of recommendation: B. Other reviewed filler agents received grade of recommendation: C or D. Poly-L-lactic acid may be best for treatment over temples and cheeks, whereas calcium hydroxylapatite, with a Food and Drug Administration indication of subdermal implantation, may be best used deeply over bone for focal enhancement. Additional long-term randomized controlled trials are necessary to elucidate the advantages and disadvantages of fillers that have different biophysical properties, in conjunction with cost-effectiveness analysis, for treatment of HIV FLA.
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Affiliation(s)
- Jared Jagdeo
- Dermatology Service, Sacramento Department of Veterans Affairs Medical Center, Mather, California; Department of Dermatology, University of California Davis, Sacramento, California; Department of Dermatology, State University of New York Downstate Medical Center, Brooklyn, New York.
| | - Derek Ho
- Dermatology Service, Sacramento Department of Veterans Affairs Medical Center, Mather, California
| | - Alex Lo
- College of Medicine, State University of New York Downstate Medical Center, Brooklyn, New York
| | - Alastair Carruthers
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
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Ghasemi HM, Damsgaard TE, Stolle LB, Christensen BO. Complications 15 years after breast augmentation with polyacrylamide. JPRAS Open 2015. [DOI: 10.1016/j.jpra.2015.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
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Abstract
A plethora of soft tissue fillers have been developed within the past decade to correct the cutaneous changes that occur with photoaging. Such fillers, whether nonpermanent, semipermanent, or permanent, are widely used to fill undesired facial rhytides. In addition, fillers are employed to correct atrophy of the face as well as other parts of the body such as the dorsum of the hands through volumization and contouring. The extensive long-term safety outcomes reported with fillers and the ease with which they are administered make them an ideal choice to correct rhytides and to contour the face. However, as with any cosmetic procedure, in order to ensure high patient satisfaction and a safe outcome, proper training in injection techniques, the choice of the proper candidate, and awareness of potential adverse events are essential. This review article focuses on the permanent filler, Aquamid, which is composed of polyacrylamide hydrogel.
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Affiliation(s)
- Paul S Yamauchi
- Dermatology Institute and Skin Care Center, Santa Monica, CA, USA ; Division of Dermatology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
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Rauso R, Colella G, Parlato V, Tartaro G. The use of microcannula for facial wasting rehabilitation with polyacrylamide gel injection: is it better than needle? J Craniofac Surg 2014; 25:1129-30. [PMID: 24777006 DOI: 10.1097/scs.0000000000000550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- Raffaele Rauso
- Univeristy of Foggia, Foggia and Plastic Surgery Department "La Sapienza" University Rome, Italy Centro Polispecialistico Santa Apollonia Santa Maria Capua Vetere Caserta, Italy dr.raffaele. Head & Neck Department Second University of Naples Naples, Italy Second University of Naples Naples, Italy Head & Neck Department Second University of Naples, Naples and Centro Polispecialistico Santa Apollonia Santa Maria Capua Vetere Caserta, Italy
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Rauso R, Curinga G, Rusciani A, Colella G, Amore R, Tartaro G. Safety and Efficacy of One-Step Rehabilitation of Human Immunodeficiency Virus-Related Facial Lipoatrophy Using an Injectable Calcium Hydroxylapatite Dermal Filler. Dermatol Surg 2013; 39:1887-94. [DOI: 10.1111/dsu.12358] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kadouch JA, van Rozelaar L, Karim RB, Hoekzema R. Current treatment methods for combination antiretroviral therapy-induced lipoatrophy of the face. Int J STD AIDS 2013; 24:685-94. [DOI: 10.1177/0956462412474539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Summary Combination antiretroviral therapy (CART) reduces the mortality and morbidity in HIV-infected patients. However, facial lipoatrophy (FLA) is one of the well-known side-effects of this treatment and subsequently imposes major problems for HIV-infected patients. In the last decade, ample experience has been obtained with both local therapeutic options as well as possible systemic treatment options. Soft tissue fillers are a relatively simple and efficient treatment option for FLA. Especially, the biodegradable semi-permanent fillers combine a good effect with durability and an acceptable safety profile. The best way to prevent or restrict the development of FLA remains the exclusion of thymidine analogue nucleoside reverse-transcriptase inhibitors from the CART schedule.
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Affiliation(s)
- J A Kadouch
- Department of Dermatology, VU Medical Centre, Amsterdam, The Netherlands
| | | | - R B Karim
- Department of Plastic, Reconstructive and Hand Surgery, Onze Lieve Vrouwe Gasthuis (OLVG), Amsterdam, The Netherlands
| | - R Hoekzema
- Department of Dermatology, VU Medical Centre, Amsterdam, The Netherlands
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Gakhar H, Kamali A, Holodniy M. Health-related quality of life assessment after antiretroviral therapy: a review of the literature. Drugs 2013; 73:651-72. [PMID: 23591907 PMCID: PMC4448913 DOI: 10.1007/s40265-013-0040-4] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Antiretroviral (ARV) treatment for HIV infection has resulted in significant improvement in immunologic and virologic parameters, as well as a reduction in AIDS-defining illnesses and death. Over 25 medications are approved for use, usually in combination regimens of three or four ARVs. Several ARVs are now available as combinatorial products, which have been associated with better adherence. However, while ARV therapy has prolonged life, ARVs also pose a challenge for quality of life as they can cause significant side effects in addition to the potential for drug toxicity and interaction. Given the many complications, side effects and symptoms of HIV/AIDS in addition to associated medical and psychiatric co-morbidities, the need to understand and assess how these interactions may affect health-related quality of life (HRQOL) has grown. Numerous instruments (some validated, others not) are available and have been applied to understanding how ARV treatment affects HRQOL in those with HIV infection, both in clinical trials and clinical practice. In general, ARV treatment improves HRQOL, but this is dependent on the population being studied, the HRQOL instrument being used and the timeframe during which HRQOL has been studied. This article provides a review of the literature on quality of-life assessment as it relates to ARV treatment in developed countries and briefly reviews the HRQOL instruments used, how they have been applied to ARV utilization, and where future research should be applied in HRQOL assessment and HIV infection.
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Affiliation(s)
- Harleen Gakhar
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Amanda Kamali
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Mark Holodniy
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA. VA Palo Alto Health Care System, 3801 Miranda Ave. (132), Palo Alto, CA 94304, USA
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Lafaurie M, Dolivo M, Girard PM, May T, Bouchaud O, Carbonnel E, Madelaine I, Loze B, Porcher R, Molina JM. Polylactic acidvs.polyacrylamide hydrogel for treatment of facial lipoatrophy: a randomized controlled trial [Agence Nationale de Recherches sur le SIDA et les Hépatites Virales (ANRS) 132 SMILE]. HIV Med 2013; 14:410-20. [DOI: 10.1111/hiv.12021] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2012] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - T May
- Department of Infectious Diseases; Brabois Hospital; Vandoeuvre les Nancy; Paris; France
| | - O Bouchaud
- Department of Infectious Diseases; Avicenne Hospital; Bobigny Cedex; France
| | - E Carbonnel
- Department of Dermatology; E. Herriot Hospital; Lyon Cedex; France
| | - I Madelaine
- Pharmacy; Saint-Louis Hospital; Paris; France
| | | | - R Porcher
- Department of Biostatistics; Saint-Louis Hospital; Paris; France
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