Comparing efficacy and costs of four facial fillers in HIV-associated lipodystrophy: a clinical trial.

BACKGROUND:The objective was to evaluate and compare safety and effectiveness of four different dermal fillers in the treatment of facial lipoatrophy secondary to Human Immunodeficiency Virus (HIV). METHODS:We conducted a clinical trial including 147 patients suffering from HIV-induced lipoatrophy treated with Sculptra® (poly-L-lactic acid), Radiesse® (calcium hydroxylapatite), Aquamid® (polyacrylamide) or autologous fat. Objective and subjective changes were evaluated during a 24-monthfollow-up. Number of sessions, total injected volume and overall costs of treatment were also analyzed. A comparative cost-effectiveness analysis of the treatment options was performed. RESULTS:Objective improvement in facial lipoatrophy, assessed by the surgeon in terms of changes from baseline using the published classification of Fontdevila, was reported in 53% of the cases. Patient self-evaluation showed a general improvement after the use of facial fillers. Patients referred to be satisfied with the treatment and with the reduced impact of lipodystrophy on their quality of life. Despite the non-significant differences observed in number of sessions and volume, autologous fat showed significantly lower costs than all synthetic fillers (p