Lessening the load of lipoatrophy
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Doctors are taking facial lipoatrophy (LA - fat wasting) far more seriously
and are increasingly choosing drug regimes thought less likely to cause
it.
Dr Ed Wilkins of North Manchester Hospital told the 8th British HIV Association
Conference on 20 April that 25 per cent of his patients showed some LA
and about five per cent had it 'severely'. Patient who switched from d4T
or PIs to AZT or abacavir regained fat.
But the gain in fat after switching was only in the region of six to 12
per cent over a year or two. He said: "This is not enough to be
Graeme Moyle: "New-Fill is psychotherapy in a needle"
discernible to the patient, and I don't think switching regimes is likely
to be enough ever to completely reverse LA."
He reviewed the current availability in the UK of New-Fill (polylactic
acid), the injectable therapy which, by thickening skin layers, reduces
the appearance of facial LA. Currently only three hospitals (North Manchester,
Chelsea and Westminster, and Ealing) offer New-Fill treatment, with only
100 patients treated so far. This contrasts with France, where one in
six of all patients have access to the treatment.
Dr Wilkins urged the NHS to adopt and pay for New-Fill as a standard procedure,
and to institute proper training and indemnity insurance for doctors performing
it. A single New-Fill treatment involves 30 injections and a degree of
skill associated with
plastic surgery, "but we have had to push and push plastic surgeons to be willing to do it."
