Synthetic polymer found effective in treating 'facial wasting' in some HIV sufferers

Padua, Italy -- Researchers at the University of Padua report that injections of a synthetic polymer may be helpful in treating some HIV patients’ facial wasting associated with combination antiretroviral therapy.

According to the study, which was reported in the March issue of the Archives of Dermatology, injections of polylactic acid significantly improved facial lipoatrophy in 50 HIV-positive patients. The procedures, unlike previous interventions, were conducted in outpatient conditions, without chemoprophylaxis. The study reports few adverse events, and among patients who experienced side effects, none stopped the treatment because of them.

The researchers report that at the start of the study, more than half the patients said they had severe facial lipoatrophy. After they were treated with the injections, none of the patients considered their lipoatrophy severe, and at month 12 of follow-up, only two thought it was severe. Four sets of injections were given: at baseline and on days 30, 45, and 60. In extremely severe cases, two more sets of injections -- on the 75th and 90th days -- were administered. No prophylactic antibiotics or local anesthesia were used.

The most frequent adverse events reported were transient edema and ecchymosis at the injection sites. Some patients also reported skin erythema, which was resolved with corticosteroids, and one patient had an ophthalmic herpes zoster infection, which was successfully treated with oral Zovirax (acyclovir, GlaxoSmithKline). A total of 15 patients reported any adverse effects at all.

The researchers concluded that the procedure is effective and safe and, unlike earlier interventions involving autologous fat or silicone implants, did not require a hospital stay or anesthesia. The study noted, however, that 28 of the 50 patients had to have additional injections within 18 months of the end of follow-up to maintain satisfactory results.

Polylactic acid, a synthetic polymer of lactic acid, has been used in reconstructive surgery for 20 years, and under the brand name Sculptra (Dermik) was approved by the Food and Drug Administration in 2004 to help correct facial lipoatrophy in people with HIV.