Long-Term Efficacy and Safety of Polyacrylamide Hydrogel Injection in the Treatment of Human Immunodeficiency Virus–Related Facial Lipoatrophy

G, De Santis; Pignatti, Marco; Baccarani, Alessio; Pedone, Antonio; Spaggiari, Andrea; Orlando, Gabriella; Guaraldi, Giovanni

doi:10.1097/prs.0b013e3182362142

Cited by 25 publications

(25 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Safety was mainly assessed 2 years after the infiltrations, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] although some publications have reported a longer followup-up to 4-5 years-in the case of polyacrylamide gel. [20][21][22][23] Data from this report are particularly relevant, considering that polyacrylamide gel is a permanent filler for which no data are available beyond 5 years. Our data support the benefits of polyacrylamide gel in terms of cosmetic results and patient satisfaction 10 years after infiltration in patients with mostly severe or very severe facial lipoatrophy.…”

Section: Discussionmentioning

confidence: 94%

“…Infiltrations with synthetic substances or autologous fat were offered to many patients affected with facial lipoatrophy. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Since some of the fillers were permanent substances, their long-term safety remains a concern, although preliminary results show a low prevalence of short-term and medium-term complications. [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] …”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ten-Year Safety with Polyacrylamide Gel Used to Correct Facial Lipoatrophy in HIV-Infected Patients

Negredo

Ornelas

Echeverría

et al. 2015

AIDS Research and Human Retroviruses

View full text Add to dashboard Cite

Long-term results (>5 years) for synthetic substances used to repair facial lipoatrophy have not been published. We performed a cross-sectional study to evaluate the 10-year safety of polyacrylamide hydrogel (Aquamid) among the 751 patients from our unit who received facial infiltrations at least 10 years ago. Epidemiological and clinical data such as complications and patient satisfaction were collected. We also identified those patients who presented a facial infection at any time after infiltration. A total of 104 patients had received Aquamid at least 10 years ago. Before infiltrations, 24.0%, 41.3%, and 34.7% presented very severe, severe, and moderate facial lipoatrophy, respectively. After a mean (SD) of 10.3 (0.5) years since the infiltrations, 19.2%, 47.7%, and 31.7% of patients reported moderate, mild, and no signs of facial lipoatrophy. The values reported by physicians for the same categories were 1.9%, 10.6%, and 87.5%. Indurations were detected in 6.7% of patients and nodules in 3.8%. Five patients (4.8%) had a local infection. A further 15 patients with a shorter follow-up (less than 10 years) presented local infections (overall incidence considering the 751 patients who received infiltrations of Aquamid, 2.7%); the product had to be withdrawn in three cases. The majority of patients were highly satisfied (74.8%) or satisfied (23.4%) with the cosmetic results; among patients with severe or very severe lipoatrophy at baseline, 31.4% were satisfied and 65.7% were highly satisfied. Infiltrations with polyacrylamide hydrogel (Aquamid) are a safe strategy for the treatment of facial lipoatrophy in the long term. The rate of severe complications was low, and patient satisfaction with the cosmetic results was high. However, facial infections may appear in the long term. Therefore, HIV-infected patients who received synthetic substances should be carefully monitored over time.

show abstract

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Ten-Year Safety with Polyacrylamide Gel Used to Correct Facial Lipoatrophy in HIV-Infected Patients

Negredo

Ornelas

Echeverría

et al. 2015

AIDS Research and Human Retroviruses

View full text Add to dashboard Cite

show abstract

“…Adjuvants increase the innate immune response by mimicking evolutionary conserved molecules, for instance bacterial wall components, and binding to toll-like receptors with further release of inflammatory cytokines from T-helper and mast cells. In HIV-positive patients, the altered cellular immune response may result in a different reaction to permanent filler implants, and delayed-type complications are far more common [8,9].…”

Section: Discussionmentioning

confidence: 99%

Massive Hemi-facial Edema After Permanent Filler Removal in an HIV-Positive Patient. Precautions and Patient Information

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Some authors define the primary end point as the proportion of responders (patients with a TCT > 10 mm after treatment) [62], while others have considered any significant change in TCT as a response parameter [63,64]. It should be noted that none of this studies have used US evaluation alone.…”

Section: Dermal Fillersmentioning

confidence: 99%

“…The total cutaneous thickness (TCT) (epidermal, dermal and subcutaneous) has been assessed to evaluate HIV-patients with facial fat atrophy before and after treatment with polylactic acid [62], HA [63] and polyacrylamide gel [64] as a follow-up parameter. Some authors define the primary end point as the proportion of responders (patients with a TCT > 10 mm after treatment) [62], while others have considered any significant change in TCT as a response parameter [63,64].…”

Section: Dermal Fillersmentioning

confidence: 99%

Ultrasound and dermatology: basic principles and main applications in dermatologic research

Bagatin

Caetano

Soares

2013

Expert Review of Dermatology

View full text Add to dashboard Cite

Ultrasound imaging has been increasingly used in dermatologic research over the past four decades. This paper aims to review its use as a disease severity and treatment efficacy assessment tool, with emphasis on the past five years. Quantitative parameters such as skin thickness, overall echogenicity, echogenicity distribution, dermal-subcutaneous interface length or area are used. The authors review skin aging, cellulite, striae, fillers, scleroderma, hypertrophic scar, wounds and psoriasis studies, and discuss correlation between sonographic findings and clinical assessment and/or validated scores. Data are still insufficient to support ultrasound imaging use as an unique efficacy assessment method in a trial, but favor that it is a valuable adjuvant assessment tool that brings objectiveness to subjective clinical assessment. Further studies and technology improvement will expand its applications in dermatology. KEYWORDS: dermatology • lipodystrophy • localized scleroderma • psoriasis • scars • skin aging • systemic scleroderma • ultrasonography • ultrasound biomicroscopy • wound healingUltrasonography has been used in medicine for more than 50 years and is one of the most frequently applied diagnostic tools. It is a noninvasive and non-ionizing method with a relatively low cost when compared with computed tomography and scintigraphic scanning techniques [1]. Alexander and Miller were the pioneers in the use of ultrasound (US) in dermatology since 1979 [2]. They demonstrated a15 MHz one-dimensional (A-scan) US equipment that measured the skin thickness with similar accuracy to the radiological techniquethe most accurate non-invasive method so far. Three years later its reproducibility and validation was shown, although the skin thickness determined in vitro was found to be greater than when in vivo determinations were made, probably due to the release of in vivo tension within the dermis [3].The 20 MHz bidimensional (B-scan) US units were first available in the 1980s, thanks to the emergence of mechanical transducers that enabled the cross-sectional imaging of the skin [4]. From then on, studies have evaluated its application in a range of skin conditions with different aims: disease severity and treatment response evaluation, adjunct diagnostic tool, tumor dimensions assessment and other uses. This paper reviews the state of art of US imaging in dermatologic research, focusing on its role as a disease severity and/or treatment efficacy assessment tool, with emphasis on the most frequently reported applications over the past five years. The use of US as a diagnostic tool or for tumor dimension assessment is not discussed here. ConceptsUS is a mechanically propagated wave with frequency above 20 kHz -the upper frequency limit of human hearing [5]. US transducers are made out of piezoelectric materials that generate acoustic energy when a voltage is applied to them. The US beam is transferred as a pulse from the transducer to the adjacent fluid or tissue and propagates as a wave, which can be reflected or refract...

show abstract

Long-Term Efficacy and Safety of Polyacrylamide Hydrogel Injection in the Treatment of Human Immunodeficiency Virus–Related Facial Lipoatrophy

Abstract: : Therapeutic, IV.

Cited by 25 publications

References 21 publications

Ten-Year Safety with Polyacrylamide Gel Used to Correct Facial Lipoatrophy in HIV-Infected Patients

Ten-Year Safety with Polyacrylamide Gel Used to Correct Facial Lipoatrophy in HIV-Infected Patients

Massive Hemi-facial Edema After Permanent Filler Removal in an HIV-Positive Patient. Precautions and Patient Information

Ultrasound and dermatology: basic principles and main applications in dermatologic research

Contact Info

Product

Resources

About