Safety and Efficacy of Poly-L-Lactic Acid in HIV-Lipoatrophy and Lipoatrophy of Aging

Background: Poly-L-lactic acid (PLLA) is an injectable filler used for the treatment of facial fat loss secondary to HIV and aging. The US FDA approved PLLA for the treatment of HIV lipoatrophy in August 2004. Observations: Sixty-five patients were treated with PLLA; 27 were HIV positive and 38 were HIV negative. The HIV patients had more severe facial lipoatrophy at presentation and improved more given their level of severity. The HIV positive patients required more treatment sessions and more PLLA to reach full correction than the non-HIV patients. Ninety-four percent of all patients had no complications and the effects of PLLA were similar in both groups. All complications were temporary and resolved over time. Patient satisfaction metrics indicated that all patients were “very satisfied” with their treatment. The HIV lipoatrophy patients indicated marked quality of life improvement. Conclusions: PLLA is a safe, efficacious, and satisfying treatment for facial fat loss associated with HIV and aging.