Double-blind clinical trial to compare autologous fat grafts versus autologous fat grafts with PDGF: no effect of PDGF.

BACKGROUND

This work evaluates the effect of adding platelet-derived growth factor to autologous adipose tissue grafts in the treatment of human immunodeficiency virus facial lipoatrophy by means of objective measurements.

METHODS

This is a randomized clinical trial conducted at the Hospital Clinic of Barcelona. Patients with facial human immunodeficiency virus atrophy were randomized into two groups, one treated with autologous fat injection (group A), and another treated with autologous fat injection with plasma rich in growth factors (group B). Before the treatment, structural changes were identified in facial soft tissue by means of computed tomography, and clinical changes were also assessed by means of photographic records. Posttreatment assessments were repeated after 2 and 12 months to compare the results. Posttreatment complications were recorded.

RESULTS

Forty-nine patients (33 men and 16 women), with a mean age of 46 years, participated in the study. In both groups, there was a statistically significant average increase of volume in the facial area measured by computed tomography between the baseline and the 2- and 12-month posttreatment assessments. All cases showed an improvement of the clinical facial atrophy grade after treatment, which was statistically significant. This improvement was related to a statistically significant fat volume increase measured by means of computed tomography. There was no difference in the volume gain between both groups. No major complications were observed.

CONCLUSIONS

Fat grafting is a safe, effective, and durable treatment for human immunodeficiency virus facial atrophy. The results of this study show that it is not necessary to add plasma rich in growth factors to the adipose tissue graft to get a better result.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, II.