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Cost consequences of HIV-associated lipoatrophy.

机译：HIV相关脂肪萎缩的成本后果。

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HIV-associated lipoatrophy may affect up to 35% of patients who have received antiretroviral (ARV) regimens for more than one year, and may result in depression, social isolation, and career barriers. Interventions including the injection of dermal fillers for restoration of facial fat loss are being used for treating HIV-associated lipoatrophy. Since reimbursement is often lacking, patients must consider the pros and cons of such interventions, weighed against the other costs of daily life. The primary goal of the study is to provide reliable estimates of the costs of treating HIV-associated lipoatrophy, specifically facial lipoatrophy. Costs are provided for a single site and are estimated from published studies reporting administration patterns of dermal fillers, publicly available list prices, and physician service fees for similar subcutaneous injections of the face. Fourteen studies were identified that reported experience with five dermal fillers used to treat HIV-associated facial lipoatrophy: poly-L-lactic acid, calcium hydroxylapatite, polyalkylimide gel, hyaluronic acid, and silicone oil. Typical courses involve four physician visits, but could vary from 1 to 13. The cost of a course of dermal filler treatment at a single site ranges across four products (all other than hyaluronic acid) from Dollars 3690 to Dollars 16,544, and is typically not covered by the payers. Physician fees for an entire course of similar outpatient procedures reimbursed by insurers are approximately Dollars 500, and may vary according to location, specialty, and market conditions. These procedures need to be repeated per site injected with intervals of 1-3 years. Treatment of HIV-associated lipoatrophy may represent a considerable out-of-pocket expense for many patients with HIV. This could have implications for deciding whether to undergo a restorative procedure, which procedure to undergo, and whether to pursue other options that may include switching ARV regimens.
机译：与HIV相关的脂肪萎缩症可能会影响接受抗逆转录病毒（ARV）方案治疗超过一年的患者中的35％，并可能导致抑郁，社交孤立和职业障碍。包括注射真皮填充剂以恢复面部脂肪流失的干预措施正在用于治疗HIV相关的脂肪萎缩。由于经常缺乏补偿，因此患者必须考虑此类干预措施的利弊，并权衡日常生活的其他费用。该研究的主要目的是提供治疗HIV相关脂肪萎缩症（尤其是面部脂肪萎缩症）费用的可靠估算。费用是由一个地点提供的，并根据已发表的研究进行估算，这些研究报告了皮肤填充剂的给药方式，可公开获得的价格以及类似的面部皮下注射的医生服务费。鉴定出的十四项研究报告了用于治疗与HIV相关的面部脂肪萎缩症的五种皮肤填充剂的经验：聚L-乳酸，羟磷灰石钙，聚烷基酰亚胺凝胶，透明质酸和硅油。典型的课程包括四次就诊，但可能从1到13次不等。在单个部位进行皮肤填充剂治疗的课程涵盖了四种产品（透明质酸以外的所有产品），价格从3690美元到16,544美元不等。由付款人支付。保险公司报销的整个类似门诊程序的医师费用约为500美元，并且可能会因地点，专业和市场条件而异。每个部位需要重复这些程序，间隔为1-3年。与HIV相关的脂肪萎缩的治疗可能代表了许多HIV患者的自付费用。这可能对决定是否要进行恢复性手术，要进行哪种手术以及是否寻求其他选择（包括改变抗逆转录病毒治疗方案）具有影响。

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