Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
Bay Area Reporter - May 21, 2009
Matthew S. Bajko, m.bajko@ebar.com
"On my 51st birthday is when it was really at a point I just didn't want to go out. I didn't want anybody to see me," recalled Wolonsky, who will turn 60 next month.
Known as facial wasting, the condition's medical term is lipoatrophy. Doctors are unclear exactly what causes it but believe that the antiretroviral drug D4T, or stavudine (Zerit), is the main culprit.
As the drug eats away at a person's fat cells, their cheeks begin to fade away and their facial appearance becomes gaunter. Many men will grow beards in an effort to hide the condition.
"It took a couple years to get there. Then all of a sudden one day I looked in the mirror and said 'Oh, my God! Is that what I really look like?'" said Wolonsky, who tried to conceal his appearance behind facial hair.
But he said, "It was not working, which made me want to stay in even more. I didn't like being seen by people."
Five years ago he heard about a new treatment doctors were using to reverse the facial wasting. They inject the drug Sculptra, made by Dermik, which is the United States arm of the French company Sanofi Aventis, into a person's face to replace the lost fat cells.
Depending on how advanced the condition is, a person may need anywhere from one to six treatments. Once complete, the effects from Sculptra should last up to three years before a person needs to return for a new round of treatments.
Wolonsky contacted a dermatologist and underwent the procedure. After several visits, it took and he regained his full-figured face.
"It was a 360 degree turnaround. I just feel good about myself," said Wolonsky, who also regained his social life. "I go out and meet people."
Treating facial wasting does not come cheap, however, and for many people living with HIV on fixed incomes, it is a luxury they cannot afford. Only a few health insurance plans cover the procedure, which can run as high as $1,500 per treatment.
"Very few patients can afford it," said Dr. Marcus Conant, whose practice is based on Castro Street and is one of the few doctors seeing AIDS patients who also performs the procedure at a discounted rate.
And the problem is widespread. In individuals infected with HIV who are taking anti-retrovirals, within four years more than half develop lipodystrophy syndrome, said Conant. He sees 10 people per week coming in for treatment.
For those making less than $40,000 per year, they can receive the drug for free but must pay for doctor costs, which can range from $300 up to $600.
"People living on $19,000 a year literally can't afford to have it done. What do they do? They just don't go out," said Conant. "They sit at home."
To help those individuals for whom treating their lipodystrophy is out of reach, while at the same time raising money for his Conant Foundation, which is struggling amid the economic downturn, Conant and his board are launching a series of fundraisers this summer aimed at addressing both concerns.
Beginning this Sunday at the Mix bar on 18th Street, and each Thursday night throughout the month of June, the Conant Foundation is hosting $10 per person beer benefits at the bar to raise money to fund its philanthropic work.
In exchange, Conant and other volunteer doctors will treat for free up to 10 patients with lipodystrophy one Saturday per month. Mark Illeman, a family nurse practitioner, has also volunteered his time to give free Sculptra treatments.
Conant is hopeful more medical providers will join his foundation's campaign and donate their time. And he argues it is to bar owners' and bartenders' advantage to support the cause.
"It is good for patients to restore their self-esteem. And it is good for the bartenders when the guys can go out again," he said.
The event this weekend runs from 3 to 8 p.m. Sunday, May 24 at the Mix.
For more information, visit http://conantfoundation.org/.
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