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Polylactic Acid vs Polyacrylamide for Facial Lipoatrophy
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Psychometric evaluation in patients undergoing fillers injections for the treatment of HIV-related facial lipoatrophy: polylactic acid versus polyacrylamide
7th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV. November 13-16, 2005, Dublin, Ireland
G Guaraldi 1, G Orlando1, M Vandelli 2, M De Paola2, D Comelli2, G De Santis1, A Pedone1, A Spaggiari1, A Baccarani1, M Pinelli 1, D De Fazio3, M Blini 3, V Borghi1, G Nardini1, B Beghetto1 and R Esposito1
1University of Modena and Reggio Emilia, Italy; 2Psychosocial Service, Azienda Ospedaliera Policlinico Modena, Italy; 3San Raffaele Hospital, Milan, Italy and Casa di cura S. Pio X, Milan, Italy
ABSTRACT 45
Antiviral Therapy 2005; 10:L29
Objectives: Fillers injections can represent an effective treatment for HIV-related face lipoatrophy. The aim of this study was to analyse quality of life (QoL), depression and body image perception in a cohort of patients undergoing
polylactic acid or polyacrylamide injections for face lipoatrophy using a set of questionnaires.
Methods: A 0 to 10 visual analogue scale was used to assess satisfaction with aesthetic results. Beck Depression Inventory, MOS-HIV, Assessment of Body Change and Distress (ABCD with its subscales: body image satisfaction, BIS and psychological and social distress, PSD) questionnaires have been used to valuate the impact of polylactic acid or polyacrylamide injections respectively
on depression, QoL and body image perception one year after treatment.
Results:
--Forty-one HIV patients receiving fillers injections have been analysed 1 year after treatment - 17 had undergone injections of polylactic acid (PLA), 24 of polyacrylamide (PAC).
--VAS aesthetic satisfaction with face increased in PLA group from 3.42 ±3.15 to 7.16 ±2.29 P<0.0001, in PAC from 2.59 ±1.94 to 7.04 ±1.58 P<0.0001.
--Depression score improved in both groups (PLA D score 3.58 ±4.52 P=0.005; PAC D score 3.08 ±6.93 P=0.040).
--No significant difference in depression score and aesthetic satisfaction improvement was found between the two groups.
--QoL domains of role function, vitality, health distress and cognitive function
improved in both groups but with no statistically significant difference within and among the groups.
--BIS improved in PAC group (DBIS -0.81 ±1.07 P<0.0001) and in PLA even if not statistically significant (DBIS -0.47 ±1.26 P=0.120). PSD improved in all groups: PLA DPSD 7.12 ±1.51 P=0.026; PAC DPSD 8.96 ±16.20 P=0.009.
--No difference in body image satisfaction emerged between groups.
Conclusions: Psychometric tools can be sensitive indicators to assess the psychological distress of people with HIV-related face lipoatrophy and to monitor the efficacy of surgical procedures. QoL evaluation needs new instruments to analyse the role of lipodystrophy and of face lipoatrophy in a new era of HIV infection.
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