Murdoch University Research Repository

Welcome to the Murdoch University Research Repository

The Murdoch University Research Repository is an open access digital collection of research
created by Murdoch University staff, researchers and postgraduate students.

Learn more

Poly-l-lactic acid for HIV-1 facial lipoatrophy: 48-week follow-up

Carey, D., Baker, D., Petoumenos, K., Chuah, J., Rogers, G.D., Watson, J., Cooper, D.A., Emery, S., Carr, A. and Nolan, D. (2009) Poly-l-lactic acid for HIV-1 facial lipoatrophy: 48-week follow-up. HIV Medicine, 10 (3). pp. 163-172.

PDF (OnlineOpen) - Published Version
Download (217kB)
Link to Published Version:
*Subscription may be required


Poly-l-lactic acid (PLA) injections modestly increase objectively assessed facial thickness but not facial soft tissue volume (FSTV) over 24 weeks. The durability of this response has not been well defined objectively.

HIV-infected lipoatrophic adults were randomized to four open-label PLA treatments administered every 2 weeks from week 0 (immediate group, n=50) or from week 24 (deferred group, n=50). Endpoints included FSTV assessed by computed tomography, facial lipoatrophy severity, quality of life (QoL) and safety. Analyses were by intention to treat.

Between weeks 24 and 48, soft tissue thickness increased modestly in injection planes, at the maxillary [mean 0.9 mm; 95% confidence interval (CI) 0.3-1.5 mm; P=0.007] and base of nasal septum levels (mean 0.4 mm; 95% CI 0.1-0.8; P=0.021), but not in untreated areas (P=0.79 and P=0.24). PLA durability assessed at week 48 in immediate group participants showed a mean change in FSTV of 14 cm(3) (95% CI-1 to 29 cm(3); P=0.060) and increased tissue depth at the maxillary (P<0.0001), base of nasal septum (P<0.0001) and mandibular (P=0.0035) levels. At week 48, clinicians and patients subjectively assessed facial lipoatrophy severity as reduced in immediate participants (83 and 91%, respectively), and the Mental Health scale score of the Short Form-36 Health Survey improved significantly in immediate participants relative to deferred participants (P=0.027). Subcutaneous injection-site nodule incidence at 48 weeks was 10%.

PLA treatment benefits were durable, with objectively assessed modest increases in facial volume and tissue thickness sustained over 48 weeks in injection planes but not in other facial areas. Improvements in some QoL domains were maintained.

Item Type: Journal Article
Murdoch Affiliation(s): Centre for Clinical Immunology and Biomedical Statistics
Publisher: Blackwell Publishing
Copyright: 2009 British HIV Association
Notes: David Nolan appears on behalf of the FLASH investigators
Item Control Page Item Control Page


Downloads per month over past year