Characterisation of Clinical Epidemiological Profie of Patients with Facial Lipoatrophy, Living with Aids, Submitted to Facial Filling with Polymethylmethacrylate
DOI:
https://doi.org/10.3823/1719Keywords:
Antiretroviral Therapy. HIV. Lipodystrophy. Polymethylmethacrylate..Abstract
Background : Patients living with AIDS and on Antiretroviral Therapy are likely to develop Lipodystrophy syndrome. Soft tissue filler with Polymethylmethacrylate is an option to treat Facial Lipoatrophy. It is a small procedure performed on an outpatient basis. Aimet to characterise the clinical and epidemiological profile of patients living with AIDS, who developed Facial Lipoatrophy and who underwent facial filler with Polymethylmethacrylate.
Methods:
A descriptive, observational study with 63 patients with AIDS, Facial Lipoatrophy, submitted to facial filling with Polymethylmethacrylate. As sources for data collection, data were analysed from records, and the Protocol Lipodystrophy Clinic of the Municipal STD/AIDS and Viral Hepatitis of São Bernardo do Campo, in São Paulo, Brazil, of patients treated between January and July 2009.
Results: On average, HIV was diagnosed for 11.5 years, mean duration of antiretroviral therapy for 10 years and mean duration of 3.8 years for Facial Lipoatrophy. Most made use of Stavudine and/or Efavirenz. At the beginning of treatment, the mean dosage of CD4 was 284 cells/mm ³ and at the time of filling the average was 709 cells/mm³. Cholesterol levels were elevated in 44.4%, and the triglycerides were elevated in 66.7%. here were practically no adverse effects from the filling.
Conclusion: On average, HIV was diagnosed for 11.5 years, mean duration of antiretroviral therapy for 10 years and mean duration of 3.8 years for Facial Lipoatrophy.
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References
Carr A, Samaras K, Burton S, Law M, Freund J, Chisholm DJ, et al.: A syndrome of peripheral lipodystrophy, hyperlipidaemia and insulin resistance in patients receiving HIV protease inhibitors. AIDS. 1998 May 7, 12(7):F51-8.
Carr A, Samaras K, Thorisdottir A, Kaufmann GR, Chisholm DJ, Cooper DA. Diagnosis, prediction, and natural course of HIV-1 protease-inhibitor-associated lipodystrophy, hyperlipidaemia, and diabetes mellitus: a cohort study. Lancet. 1999 Jun 19, 353(9170):2093-9.
Panse I, Vasseur E, Raffin-Sanson ML, Staroz F, Rouveix E, Saiag P. Lipodystrophy associated with protease inhibitors. Br J Dermatol. 2000 Mar, 142(3):496-500.
Hirsch HH, Battegay M. [HIV-infection, HAART (highly-active antiretroviral therapy) and hyperlipidemia]. Dtsch Med Wochenschr. 2003 May 9, 128(19):1051-4.
Bergersen BM, Sandvik L, Ellingsen I, Bruun JN. Lipoatrophic men 44 months after the diagnosis of lipoatrophy are less lipoatrophic but more hypertensive. HIV Med. 2005 Jul, 6(4):260-7.
Lassalle S, Cervera P, Hofman V, Mari M, Dellamonica P, Hofman P. [Antiretroviral treatments-related lipodystrophy syndrome: clinico-pathological findings]. Ann Pathol. 2005 Sep, 25(4):309-17.
Loutfy MR, Raboud JM, Antoniou T, Kovacs C, Shen S, Halpenny R, et al. Immediate versus delayed polyalkylimide gel injections to correct facial lipoatrophy in HIV-positive patients. AIDS. 2007 May 31, 21(9):1147-55.
Ministério da Saúde do Brasil: Tratamento da Lipoatrofia Facial: Preenchimento com PMMA [http://www.crt.saude.sp.gov.br/resources/crt_aids/arquivosbibliotecacrt/artigospdfcompletos/manual_de_tratamento_da_lipoatrofia_facil.pdf.]
Portela MC, Lotrowska M. Assistência aos pacientes com HIV/Aids no Brasil. Rev Saúde Pública 2006, 40(Supl):70-9.
Ministério da Saúde do Brasil: Portaria nº 118 de 23 de fevereiro de 2005 [http://www.brasilsus.com.br/legislacoes/sas/4084-118.]
- Ministério da saúde do Brasil. Secretaria de Vigilância a saúde. Departamento de DST, AIDS e Hepatites Virais. Manual de tratamento de lipoatorfia facial: recomendações para o preenchimento facial com Polimetilmetacrilato em portadores de HIV/AIDS. BrasÃlia; 2009.
Alencar R, Caraciolo J, Fonsi M, et al.: Lipodystrophy: challenge and solutions [http://periodicos.ses.sp.bvs.br/scielo.php?script=sci_arttext&pid=S1806-42722010000200004&lng=pt&nrm=iso.]
O'Brien KK, Bayoumi AM, Strike C, Young NL, Davis AM. Exploring disability from the perspective of adults living with HIV/AIDS: development of a conceptual framework. Health Qual Life Outcomes. 2008, 6:76.
Tran BX, Ohinmaa A, Nguyen LT. Quality of life profile and psychometric properties of the EQ-5D-5L in HIV/AIDS patients. Health Qual Life Outcomes. 2012, 10:132.
Ministério da Saúde do Brasil: Boletim Epidemiológico Aids e DST 2013 [http://www.aids.gov.br/publicacao/2011/boletim_epidemiologico_2013.]
Martinez TLR. Alterações metabólicas presentes na infecção pelo HIV - revisão atualizada da sua etiopatogenia e tratamento. Rev Atividade CientÃfica. 2008, 3(29):3-1815.
Ribera E, Paradineiro JC, Curran A, Sauleda S, Garcia-Arumi E, Castella E, et al. Improvements in subcutaneous fat, lipid profile, and parameters of mitochondrial toxicity in patients with peripheral lipoatrophy when stavudine is switched to tenofovir (LIPOTEST study). HIV Clin Trials. 2008 Nov-Dec, 9(6):407
Paton, NI, Earnest A et al. Lipodystrophy in a cohort of human immunodeficiency virus-infected Asian patients: prevalence, associated factors, and psychological impact. Clin Infect Dis, v.35, n.10, 2002 Nov 15, p.1244-9.
Talmor M, Hoffman LA, LaTrenta GS. Facial atrophy in HIV-related fat redistribution syndrome: anatomic evaluation and surgical reconstruction. Ann Plast Surg. 2002 Jul, 49(1):11-7; discussion 117-8.
Abood A, Ong J, Withey S, Johnson M, Butler P. Facial atrophy in HIV-related fat redistribution syndrome: a plastic surgical perspective on treatment options and a look to the future. Int J STD AIDS. 2006 Apr, 17(4):217-20.
Fuller J. A 39-year-old man with HIV-associated lipodystrophy. JAMA. 2008 Sep 3, 300(9):1056-66.
Peterson S, Martins CR, Cofrancesco J. Lipodystrophy in the patient with HIV: social, psychological, and treatment considerations. Aesthet Surg J. 2008 Jul-Aug, 28(4):443-51.
Hornberger J, Rajagopalan R, Shewade A, Loutfy MR. Cost consequences of HIV-associated lipoatrophy. AIDS Care. 2009 May, 21(5):664-71.
Ministério da Saúde do Brasil: SÃndrome Lipodistrófica. [http://www.crt.saude.sp.gov.br/resources/crt_aids/arquivosbibliotecacrt/artigospdfcompletos/manual_de_tratamento_da_lipoatrofia_facil.pdf.]
Luther J, Glesby MJ. Dermatologic adverse effects of antiretroviral therapy: recognition and management. Am J Clin Dermatol. 2007, 8(4):221-33.
Joly V, Flandre P, Meiffredy V, Leturque N, Harel M, Aboulker JP, et al. Increased risk of lipoatrophy under stavudine in HIV-1-infected patients: results of a substudy from a comparative trial. AIDS. 2002 Dec 6, 16(18):2447-54.
Pereira SBG, Gastaldi BS: Prevalência. In Lipodistrofia. 1 ed. Edited by Pereira SBG. São Paulo: Livraria Santos Editora Ltda; 2007: 9-11.
Behrens G, Schmidt RE. Lipodystrophy syndrome. Flying Publisher. 2005 [http://bvsms.saude.gov.br/bvs/publicacoes/hivmedicine2006.pdf.]
Miller J, Carr A, Emery S, Law M, Mallal S, Baker D, et al. HIV lipodystrophy: prevalence, severity and correlates of risk in Australia. HIV Med. 2003 Jul, 4(3):293-301.
Ministério da Saúde do Brasil: Boletim Epidemiológico Aids 2010 [http://www.aids.gov.br/sites/default/files/anexos/publicacao/2010/45974/vers_o_final_15923.pdf.]
Ministério da Saúde do Brasil: DST, Aids e Hepatites virais. BrasÃlia; 2013.
Moyle G, Sutinen J. Managing HIV lipoatrophy. Lancet. 2004 Feb 7, 363(9407):412-4.
D`Ãmati G, Di Gioia CR, Gallo P. Pathological findings of HIV-associated cardiovascular disease. Ann NY Acad Sci 2001, 946:23-45.
Barbaro G, Di Lorenzo G, Grisorio B, Barbarini G. Cardiac involvement in the acquired immunodeficiency syndrome: a multicenter clinical-pathological study. Gruppo Italiano per lo Studio Cardiologico dei pazienti affetti da AIDS Investigators. AIDS Res Hum Retroviruses. 1998 Aug 10, 14(12):1071-7.
Valantin MA, Aubron-Olivier C, Ghosn J, Laglenne E, Pauchard M, Schoen H, et al. Polylactic acid implants (New-Fill) to correct facial lipoatrophy in HIV-infected patients: results of the open-label study VEGA. AIDS. 2003 Nov 21, 17(17):2471-7.
Mest DR, Humble G. Safety and efficacy of poly-L-lactic acid injections in persons with HIV-associated lipoatrophy: the US experience. Dermatol Surg. 2006 Nov, 32(11):1336-45.
El-Beyrouty C, Huang V, Darnold CJ, Clay PG. Poly-L-lactic acid for facial lipoatrophy in HIV. Ann Pharmacother. 2006 Sep, 40(9):1602-6.
Kavouni A, Catalan J, Brown S, Mandalia S, Barton SE. The face of HIV and AIDS: can we erase the stigma? AIDS Care. 2008 Apr, 20(4):485-7.
Bechara FG, Gambichler T, Brockmeyer NH, Sand M, Altmeyer P, Hoffmann K. Hyaluronic acid new formulation: experience in HIV-associated facial lipoatrophy. Dermatology. 2008, 217(3):244-9.
Gagnon M. Understanding the experience of reconstructive treatments from the perspective of people who suffer from facial lipoatrophy: A qualitative study. International Journal of Nursing Studies, 2011 Nov 30.
Vargas KF, Borghetti RL, Moure SP, et al. Use of polymethylmethacrylate as permanent filling agent in the jaw, mouth and face regions - implications for dental practice. Gerodontology. 2011 Apr 4.
WHO. Report on the global AIDS epidemic, Executive Summary. 2008 [http://data.unaids.org/pub/GlobalReport/2008/jc1511_gr08_executivesummary_en.pdf.]
Negredo E, Puig J, Aldea D, Medina M, Estany C, Perez-Alvarez N, et al. Four-year safety with polyacrylamide hydrogel to correct antiretroviral-related facial lipoatrophy. AIDS Res Hum Retroviruses. 2009 Apr, 25(4):451-5.
Matos AC, Boletini RS, Kating TC, Matsumoto NF, Gandolpho MA. Treatment of facial lipoatrophy in people infected by HIV/AIDS: moving away from prejudice and improving quality of life. Mundo da Saúde 2010, 34(2):210-7.30. Waitzberg DLK. Dieta, nutrição e câncer. In: Atheneu, editor. 2004: 618-24.
Castro AC, Collares MV, Portinho CP, Dias PC, Pinto RA. Extensive facial necrosis after infiltration of polymethylmethacrylate. Braz J Otorhinolaryngol. 2007 Nov-Dec, 73(6):850.
Salles AG, Lotierzo PH, Gemperli R, Besteiro JM, Ishida LC, Gimenez RP, et al. Complications after polymethylmethacrylate injections: report of 32 cases. Plast Reconstr Surg. 2008 May, 121(5):1811-20.
Niamtu J, 3rd. Filler injection with micro-cannula instead of needles. Dermatol Surg. 2009 Dec, 35(12):2005-8.
Dornelas MT et al. Bioplasty for lipodystrophy in patients with HIV/AIDS. Rev Bras Cir Plást. 2012; 27(3):387-91
Rogowska-Szadkowska D, Chlabicz S, Oltarzewska MA, Sawicka-Powierza J. Which factors hinder the decision of Polish HIV-positive patients to take up antiretroviral therapy? AIDS Care. 2009 Mar, 21(3):280-3.
Quintas RC, de França ER, de Petribú KC, Ximenes RA, Quintas LF, Cavalcanti EL, Kitamura MA, Magalhães KA, Paiva KC, Filho DB. Treatment of facial lipoatrophy with polymethylmethacrylate among patients with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS): impact on the quality of life. Int J Dermatol. 2014 Apr; 53(4):497-502.
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