Onesti M G, Renzi L F, Paoletti F, Scuderi N
Department of Plastic and Reconstructive Surgery, University La Sapienza, Rome, Italy.
Acta Chir Plast. 2004;46(1):12-5.
The recent use of antiretroviral drugs in people with HIV infection produced a drastic reduction in mortality and a remarkable improvement in the quality of life for these patients. However the aesthetic and psychological consequences that come from the reorganization of the adipose tissue induced by these drugs (facial wasting, buffalo hump) may reduce this state of wellbeing.
Our group, in cooperation with the 3rd Division of Infective Diseases of the University of Rome "La Sapienza", decided to evaluate the efficacy of polylactic acid (PLA) in combating these problems in HIV positive patients undergoing treatment with antiretroviral drugs in an evaluating study of 4 cases. The evaluation of the obtained results was performed by follow-up at one, three, six and twelve months from the first infiltration and considering the clinical evaluation, the photographical documentation and the patient's judgement.
In all cases we obtained an improvement of the local condition with the restoration of a more booming aspect. The change was noted both within the family and the work environment. In the first three cases the results were considered as optimal by both the operators and the patients. In the fourth case the result was evaluated as discreet (a remarkable loss of weight of the patient in the months following the treatment should be taken into consideration).
We think a new study with ultrasonography of dermal thickness before, during and after the treatment is necesary. This study will give a more reliable evaluation of the product efficacy.
近期抗逆转录病毒药物应用于HIV感染者,使这些患者的死亡率大幅降低,生活质量显著提高。然而,这些药物引起的脂肪组织重新分布所带来的美学和心理影响(面部消瘦、水牛背)可能会降低这种良好状态。
我们团队与罗马“萨皮恩扎”大学传染病科第三分部合作,在一项对4例患者的评估研究中,决定评估聚乳酸(PLA)对接受抗逆转录病毒药物治疗的HIV阳性患者解决这些问题的疗效。通过在首次注射后的1个月、3个月、6个月和12个月进行随访,并综合临床评估、照片记录和患者的判断来评估所得结果。
在所有病例中,局部状况均得到改善,外观恢复得更加饱满。在家庭和工作环境中都注意到了这种变化。在前3例中,操作人员和患者均认为结果最佳。在第4例中,结果被评估为尚可(应考虑到治疗后数月患者体重显著下降)。
我们认为有必要在治疗前、治疗期间和治疗后进行皮肤厚度超声检查的新研究。这项研究将对产品疗效给出更可靠的评估。