Poly-L-lactic Acid for Facial Lipoatrophy in HIV

HIV.1 Lipodystrophy syndrome is a term used to refer to 4 differ-ent, but not necessarily mutually exclusive, conditions: al-teration of metabolic profile (cholesterol, triglycerides), fat accumulation, fat redistribution, and lipoatrophy.2 Lipodys-trophy is considered, in part, to be an adverse effect of an-tiretrovirals (ARVs). In some instances, as many as 50 % of people on ARV therapy are thought to be affected by lipodystrophy.3 Documented risk factors associated with lipodystrophy syndrome include duration of ARV therapy, combined protease inhibitor and nucleoside reverse tran-scriptase inhibitor regimens (especially thymidine-contain-ing regimens), increasing age, and hepatitis C coinfection.4 Fat redistribution and accumulation are often seen in the peri-umbilical region, breast (unilaterally and/or bilateral-ly), and dorsocervical areas of an affected patient, while lipoatrophy (loss of subcutaneous fat disproportionate to overall weight or muscle loss) is observed most frequently in the buttocks, limbs, and face.5 These changes in body image may contribute to a negative effect on a patient’s quality of life and lead to suboptimal adherence to ARV treatment