Aquamid (polyacrylamide hydrogel) injections are a safe and long-lasting treatment for facial wasting, according to a study published in the April issue of AIDS Research and Human Retroviruses and reported by aidsmap.

Though the percentage of people who develop facial wasting, or lipoatrophy, has diminished since health care providers moved away from prescribing the antiretrovirals Zerit (stavudine) and Retrovir (zidovudine), a significant number of people still have untreated lipoatrophy. Moreover, the two fillers approved in the United States to treat the condition are temporary treatments and must usually be reapplied to maintain facial fullness.

To determine the long-term effectiveness and safety of a new, permanent filler called Aquamid, Eugenia Negredo, MD, from the Universitat Autònoma de Barcelona, and her colleagues treated 145 people with HIV and varying degrees of facial wasting. Most of the patients were male and had been infected with HIV for about 16 years. The average age was 47, and nearly two thirds had severe facial lipoatrophy. The patients received injections of Aquamid every three weeks until a desired fullness in the face was achieved. The authors did not state the average number of treatments that were given, but the average total volume of Aquamid used was 5.5 milliliters.

Negredo's team found that Aquamid implants were relatively safe. Only one patient had a serious infection, which was treatable with oral antibiotics. Nineteen percent had small nodules that were not readily visible, and 6 percent had hardening of the facial skin. Just 9 percent of the patients required follow-up injections after reaching a desired facial fullness during the follow-up period averaging four years.

While the authors conclude that their study demonstrates the relative efficacy and safety of Aquamid, they also caution that “continued and prolonged follow-up of these patients is recommended to treat complications and detect unexpected long-term adverse reactions.”