Safety assessments

included physical examination and recording of directly observed and spontaneously reported adverse events. Assessments performed at 12 months have been published previously in the 52-week follow-up study report [14]. Standardized ultrasonography was used to measure the total cutaneous thickness (epidermal, dermal and subcutaneous thickness) in the nasogenian buy X-396 area, which is located below the malar bone in front of the masseter muscle. The examinations were conducted by the same radiologist, using a scanner (Acuson-Siemens Sequoia 512; Siemens Medical Solutions, Mountainview, CA, USA) equipped with a 14-MHz linear array transducer. A large amount of acoustic coupling gel was used and the scanning was performed with minimal pressure. Four measurements were made from each nasogenian area and a mean value (right+left cheek)/2 was calculated at each visit. All the ultrasonographic examinations were recorded. A treatment responder was defined as a patient with a total cutaneous thickness >10 mm. Patient and physician satisfaction with treatment outcome was evaluated using the Global Aesthetic Improvement Scale [14] with scores from (1) very much improved to (5) worse. Self-satisfaction with facial appearance was recorded on a visual analogue scale (VAS) with scores from (0) not satisfied

R788 at all to (100) completely satisfied. Information about possible changes in patients’ self-esteem after treatment with hyaluronic acid was captured using the Rosenberg self-esteem scale [16] and scores ranged from (0) low self-esteem to (60) high self-esteem. These tools are described in more detail in the 52-week follow-up

study report [14]. Related samples tests were used to compare values obtained at the first and subsequent visits: the Wilcoxon signed-rank test was used for continuous variables and the McNemar test for binary variables. The level of significance used was 5%. Results are L-NAME HCl presented as mean ± standard deviation, unless otherwise stated. Twenty patients, one female and 19 male, were enrolled between September 2004 and April 2005 and are included in the study analysis. At baseline, the patients were 49 ± 7 years old and their mean weight was 74.7 ± 10.0 kg. Eighteen patients were Caucasian and two were of African descent. They had a long history of HIV infection; the mean duration from the first positive test was 13.6 years (minimum 8.5 and maximum 20.0 years), and the mean time on ART was 10.0 years (minimum 6.9 and maximum 15.6 years). All but one patient had been on stavudine (mean time on stavudine 40 ± 27 months) and 17 had stopped taking stavudine at least 1 year before inclusion. Details about the use of zidovudine were not included.