Four-Year Safety with Polyacrylamide Hydrogel to Correct Antiretroviral-Related Facial Lipoatrophy
Four-Year Safety with Polyacrylamide Hydrogel to Correct Antiretroviral-Related Facial Lipoatrophy
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DOI：
10.1089/aid.2008.0230
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发表时间：
2009-04-01
影响因子：
1.5
通讯作者：
Clotet, Bonaventura
中科院分区：
文献类型：
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作者：
Negredo, Eugenia;Puig, Jordi;Clotet, Bonaventura
合成物质渗透是修复面部脂肪萎缩的有效策略。然而，关于长期安全性的数据很少。我们描述了 2002 年 9 月至 2004 年 4 月期间接受 Aquamid 面部浸润的 145 名患者使用聚丙烯酰胺水凝胶的安全性。收集了流行病学、临床（主要是并发症）和心理数据（患者满意度）。我们还记录了所有在接受浸润后随时出现局部感染的患者。 62% 的患者在浸润前出现严重的面部脂肪萎缩。每名患者注射的 Aquamid 累积体积为 5.5 ml (4-18)。在渗透后的平均 (SD) 50.2 (4.3) 个月内，只有一名患者出现局部感染。可触及的小结节或硬结是最常见的并发症（分别为 19.3% 和 6.2%）。如果我们包括我们中心的其余也接受过 Aquamid 治疗的患者 (n=294)（尽管不到 4 年前），另外 3 名患者出现局部感染（发生率为 0.9%）。大多数患者（88.9%）对结果“满意”或“非常满意”；基线轻度至中度面部脂肪萎缩的患者比重度脂肪萎缩的患者更满意（“非常满意”：分别为 92.7% 和 86.5%）。只有 17.4% 的患者报告轻度脂肪萎缩受损，只有 9.2% 的患者需要新的浸润；然而，76% 的患者更愿意进行更多的浸润。使用 Aquamid 进行面部浸润至少 4 年后，患者满意度高，严重并发症数量少，这反映出该产品用于修复面部脂肪萎缩的长期安全性但是，建议对这些患者进行长期随访，以发现意外的长期不良反应。
Infiltrations with synthetic substances are effective strategies for repairing facial lipoatrophy. However, few data are available on long-term safety. We describe the safety of polyacrylamide hydrogel in 145 patients who received facial infiltrations with Aquamid from September 2002 to April 2004. Epidemiological, clinical (mainly complications), and psychological data (patient satisfaction) were collected. We also recorded all patients who presented with a local infection at any time after receiving an infiltration. Sixty-two percent of patients presented with severe facial lipoatrophy before infiltration. The cumulative volume of Aquamid injected was 5.5 ml (4-18) per patient. During a mean (SD) of 50.2 (4.3) months after infiltration, only one patient presented with a local infection. Small palpable, nonvisible nodules or indurations were the most frequent complications (19.3% and 6.2%, respectively). If we include the remaining patients from our center (n=294) who also received Aquamid (although less than 4 years ago), a further three patients presented with a local infection (incidence of 0.9%). Most patients (88.9%) were "satisfied'' or "very satisfied'' with the results; patients with mild to moderate baseline facial lipoatrophy were more satisfied than those with severe lipoatrophy ("very satisfied'': 92.7% versus 86.5%, respectively). Only 17.4% reported mild impairment of lipoatrophy and only 9.2% required new infiltrations; however, 76% would have preferred more infiltrations. The high patient satisfaction and the low number of severe complications after at least 4 years of facial infiltrations with Aquamid reflect the long-term safety of this product for the repair of facial lipoatrophy. However, prolonged follow-up of these patients is recommended to detect unexpected long-term adverse reactions.