Treatment of HIV lipoatrophy and lipoatrophy of aging with poly-L-lactic acid: A prospective 3-year follow-up study

Background Poly-L-lactic acid (PLLA), marketed as Sculptra (Dermik Laboratories, Bridgewater, NJ), is used for subcutaneous volume restoration. Durability studies are ongoing and longevity data are not yet available. Objective We sought to evaluate the long-term efficacy and safety of PLLA during 3 years of follow-up. Methods We conducted a prospective cohort study. Primary outcome measures were facial lipoatrophy score, complications, and patient satisfaction. Results In all, 65 patients were initially treated with PLLA; 27 patients were HIV positive and 38 were HIV negative. Of those patients, 12 were lost to follow-up. Both HIV-positive and HIV-negative patients demonstrated statistically significant improvement in facial lipoatrophy score at the end of 3 years; HIV-positive patients had a net improvement of 2.50 points ( P P Limitations Sample size was limited in this study. In addition, 12 of 65 patients (18%) were lost to follow-up between years 2 and 3. Conclusions PLLA provides volumetric correction of HIV lipoatrophy and lipoatrophy of aging. Results appear to be long lasting and correction can be maintained for up to 3 years with additional treatment sessions. In a subset of patients, correction is maintained for at least 1 year after their last treatment session. Patient satisfaction with PLLA is high.