Guaraldi G, Fazio DD, Orlando G, Murri R, Grisotti A, Nardini G, Callegari M, Lorenzi ID, Prinzivalli G, Pecorari M, Beghetto B, Covezzi R, Amorico G, Esposito R, Wu A; Conference on Retroviruses and Opportunistic Infections.
Abstr 10th Conf Retrovir Oppor Infect Feb 10 14 2003 Hynes Conv Cent Boston Mass USA Conf Retrovir Oppor Infect 10th 2003 Boston Mass. 2003 Feb 10-14; 10: abstract no. 722.
Univ di Modena e Reggio, Emilia, Italy
BACKGROUND: Autologous fat transfer has been used only rarely to treat facial lipoatrophy for fear of rapid graft loss. We assessed the objective and subjective efficacy and durability of this intervention in people with HIV and body fat redistribution (BFR).METHODS: Prospective observational cohort of 60 consecutive patients (pts), of whom 38 (63.3%) were treated. Objective evaluation included ultrasonography of the cheeks at wks 24 and 52 post-procedure. Subjective evaluation (wks 0, 24, and 52) included self-assessment of appearance on a visual analogue scale (VAS) and the Body Change and Distress (ABCD) questionnaire for psychological consequences of lipodystrophy. Quality of life was assessed using the MOS-HIV. Adherence to HAART was measured using self-report. Paired samples t-test was used to compare variables at time 0, 24, and 52 wks after surgery.RESULTS: Twenty-five (25) pts had 24 wks follow-up and 16 had 52 wks follow-up; 35% were female, mean age was 43.7 yrs, mean duration of HIV was 13.9 yrs. Mean BMI was 26,0, mean CD4 = 559 /mL (+/-321), and viral load was undetectable in 70%. All pts had been on stable HAART for at least 6 months. Ultrasound showed a 5.5 (+/-3.9) mm median increase of subcutaneous fat at 24wks and 3.5 (+/-2,4) at 52 wks. QoL data showed a significant improvement in mental health and health distress (both p < 0.05). There was a highly level of patient satisfaction: with 55% very dissatisfied pre-surgery, and only 6% post-surgery. Pts reported that the results looked natural and normal sensation of the cheeks. The ABCD questionnaire was both reliable (Cronbach's alpha > 0.89) and sensitive to changes. Adherence remained optimal during the study period. Two pts needed re-intervention due to facial asymmetry secondary to development of mild cheek fat hypertrophy.CONCLUSIONS: Preliminary results suggest that autologous fat transplant is both effective and durable using objective and subjective assessments. The ABCD was useful to identify pts who may benefit for surgery. Adherence to HAART was good both pre- and post-surgery. A limitation of this procedure is that 40% of the pts with facial wasting do not have sufficient fat to be transferred.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Adipose Tissue
- Antiretroviral Therapy, Highly Active
- Female
- HIV Infections
- HIV Seropositivity
- Humans
- Lipodystrophy
- Longitudinal Studies
- Syndrome
- Viral Load
Other ID:
UI: 102261362
From Meeting Abstracts