HIV-associated facial lipoatrophy treated with injectable silicone oil: a pilot study

J Am Acad Dermatol. 2013 Sep;69(3):431-7. doi: 10.1016/j.jaad.2013.03.025. Epub 2013 May 24.

Abstract

Background: Facial lipoatrophy (FLA) is associated with HIV infection and is part of the lipodystrophy syndrome. Temporary filler treatments do not meet the need of the patient, as there is a lack of permanence, and excessive cost.

Objective: We sought to evaluate the safety and efficacy of a highly purified medical-grade 1000-cst liquid injectable silicone in the treatment of HIV-associated FLA using the serial microdroplet injection technique.

Methods: Twenty patients with HIV-associated lipoatrophy were treated with liquid injectable silicone with a maximum of 6 treatment sessions (2.0 mL each session maximum). Patients were evaluated at 9-, 12-, and 18-month follow-up sessions. Safety, efficacy, injection volumes, and patient satisfaction were evaluated.

Results: No persistent adverse effects were reported throughout the study. Most of the patients achieved complete correction of their HIV-associated FLA after 6 treatments and maintained this correction to the 18-month follow-up.

Limitations: This is a noncomparative, nonblinded study. Study patient population size is small.

Conclusion: Given our small sample size of 20 patients, our results suggest that, if administered correctly, liquid injectable silicone is potentially a safe, effective, and natural-feeling treatment option for HIV-associated FLA. Larger studies may be needed to confirm safety, efficacy, and permanence.

Keywords: AE; CLSS; Carruthers Lipoatrophy Severity Scale; FLA; HIV-associated lipoatrophy; LIS; QOL; adverse event; facial lipoatrophy; liquid injectable silicone; permanent soft tissue filler; quality of life; silicone oil.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adipose Tissue / pathology*
  • Adult
  • Atrophy / drug therapy
  • Atrophy / virology
  • Face
  • Female
  • HIV Infections / complications*
  • Humans
  • Injections, Subcutaneous
  • Male
  • Middle Aged
  • Patient Satisfaction
  • Pilot Projects
  • Quality of Life
  • Severity of Illness Index
  • Silicone Oils / administration & dosage*
  • Silicone Oils / adverse effects

Substances

  • Silicone Oils