Marseille 2007
| Abstract #303 - The face of HIV and AIDS: can we erase the stigma? | ||||
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Session: 26.96: Posters B (Poster) on Tuesday in Chaired by Authors: Presenting Author: Ms Angelica Kavouni - Chelsea and Westminster Hospital, United Kingdom |
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| Additional Authors: | ||||
| Aim: Facial Lipoatrophy can be obvious and stigmatising. Current HIV treatment protocols have minimally improved the incidence or the morphological manifestations of lipoatrophy. Poly-L-lactic (PLLA) acid has been used widely for the correction of HIV associated facial lipoatrophy. However the most favourable treatment protocol remains under discussion. | ||||
| Method / Issue: Analysis of the PLLA treatment protocols of 441 consecutive patients was undertaken. Product dilution, product volume per session, number of sessions, time between sessions, facial areas treated, plane of injection, incidence of injection-site nodules and injection related adverse events were recorded. The presence of lipoatrophy was assessed using the Chelsea and Westminster scale. Assessments included photographs, the Hospital Anxiety and Depression Scale and the Appearance Satisfaction Questionnaire. | ||||
| Results / Comments: During the learning curve 30 patients were treated every 2 weeks for a minimum of 3 sessions. A 3ml dilution was used and a total of 5ml was injected in the deep dermis of the buccal areas. The incidence of nodule formation was 31% and 52% of patients did not achieve resolution of their facial disfigurement. 411 patients were treated every 4 weeks for a minimum of 4 sessions. A minimum 5ml dilution was used and a minimum total of 10ml was injected subcutaneously in the temporal, infraorbital and buccal areas. The incidence of nodule formation was 2.9% and 10% of patients did not achieve resolution of their facial disfigurement. Patient anxiety and depression scores and appearance satisfaction scores improved consistently and significantly with treatment. | ||||
| Discussion: The current PLLA treatment protocol for HIV associated facial lipoatrophy reduces the incidence of nodularity and the need for further treatment interventions. The improvement on anxiety, depression and appearance satisfaction was significant and consistent. | ||||
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