Modena, Italy From the Department of Plastic and Reconstructive Surgery and the HIV Metabolic Clinic, Department of Infectious and Tropical Diseases, Azienda Ospedaliero-Universitaria di Modena, University of Modena and Reggio Emilia.
Plast Reconstr Surg. 2012 Jan;129(1):101-109. doi: 10.1097/PRS.0b013e3182362142.
Facial lipoatrophy, a human immunodeficiency virus-related wasting of the facial soft tissues, can compromise patients' quality of life. Injection of different materials in the cheeks can improve this condition. Concern regarding potential long-term complications of nonbiodegradable fillers remains. The authors investigated the long-term efficacy and safety of polyacrylamide gel injections.
Human immunodeficiency virus-infected patients treated with polyacrylamide gel for moderate to severe facial lipoatrophy with a minimum of 5 years' follow-up were included. Aquamid (1 ml) was injected monthly into each cheek until adequate correction was obtained. Outcome measures were ultrasound measurement of cheek soft-tissues thickness, evaluation of aesthetic improvement, and self-evaluation of satisfaction and psychological consequences of treatment (visual analogue scale for the face, Assessment of Body Change and Distress questionnaire, and Beck Depression Inventory score). Adverse events were classified as acute (<1 week), early (1 week to 1 month), midterm (1 month to 1 year), or late (>1 year).
One hundred forty-one patients completed the treatment as of June of 2005; 38 (32 men; mean age, 42 years) were available for follow-up of more than 5 years (mean, 62 months). The mean number of treatment sessions was seven over a mean period of 8 months. Significant improvement of cheek thickness and aesthetic result and highly significant satisfaction and psychological improvement were obtained. No serious adverse events occurred during the follow-up period.
The long-term efficacy and safety of polyacrylamide gel injection for the treatment of human immunodeficiency virus-related facial lipoatrophy were shown over a period of 5 years.
CLINICAL QUESTION/LEVEL OF EVIDENCE: : Therapeutic, IV.
面部脂肪萎缩是一种与人类免疫缺陷病毒相关的面部软组织消耗，会影响患者的生活质量。向脸颊注射不同的材料可以改善这种情况。人们仍然关注不可生物降解填充物的潜在长期并发症。作者研究了聚丙烯酰胺凝胶注射的长期疗效和安全性。
本研究纳入了接受聚丙烯酰胺凝胶治疗中重度面部脂肪萎缩的人类免疫缺陷病毒感染患者，随访时间至少 5 年。每月向每侧脸颊注射 1 毫升 Aquamid，直到获得足够的矫正效果。评估指标包括脸颊软组织厚度的超声测量、美学改善评估、以及对治疗满意度和心理影响的自我评估（面部视觉模拟量表、身体变化和困扰评估问卷和贝克抑郁量表评分）。不良事件分为急性（<1 周）、早期（1 周至 1 个月）、中期（1 个月至 1 年）或晚期（>1 年）。
截至 2005 年 6 月，141 名患者完成了治疗；38 名（32 名男性；平均年龄 42 岁）患者的随访时间超过 5 年（平均 62 个月）。平均治疗次数为 7 次，治疗时间平均为 8 个月。脸颊厚度和美学效果显著改善，满意度和心理改善高度显著。在随访期间未发生严重不良事件。
聚丙烯酰胺凝胶注射治疗人类免疫缺陷病毒相关面部脂肪萎缩的长期疗效和安全性在 5 年的随访中得到了证实。
临床问题/证据水平：治疗，IV。
