Lipoatrophy in patients with AIDS: treatment with polymethylmethacrylate in Amazonas, Brazil

Background The use of antiretroviral therapy (ART) in AIDS has been associated with lipodystrophic syndrome, which is characterized by metabolic alterations and abnormal corporal fat distribution. Our goal was to describe and evaluate the use of polymethylmethacrylate (PMMA) to treat lipoatrophy in patients with AIDS from Amazonas, Brazil. Methods Patients with AIDS undergoing ART and presenting with facial lipoatrophy were invited to participate in the study. A face-to-face interview was conducted, and patients were treated with applications of PMMA 30%. Results A total of 49 cases were included. The mean age was 45 (SD 6.1) years old, and the mean educational level (measured in schooling years) was 10.5 (SD 3.2) years of schooling. The median of CD4 cell count was 482.5 (interquartile range: 338-574.5) cells/mm(3). Stavudine and zidovudine were the most frequently prescribed ART drugs. The total number of PMMA injections ranged from one to five times, and side effects were not frequent. A total of 42 (85.7%) patients reported satisfaction after a follow-up of more than 12 months, presenting good fullness of the deformity. Conclusions Our data showed that patients with AIDS with lipoatrophy related to ART could safely benefit from PMMA-based treatment.