HIV-associated lipodystrophy can cause visible changes in the way your body stores fat. It’s not an official diagnosis but rather a group of changes that some people with HIV may experience.

Lipodystrophy seems to occur from antiretroviral therapy (ART) medication, which doctors prescribe to treat HIV. Specifically, it links to taking protease inhibitors and older nucleoside reverse transcriptase inhibitors (NRTIs).

This condition can affect anyone with HIV, but it was more common when doctors prescribed early ART options. Newer medications have a much lower chance of causing lipodystrophy.

Lipodystrophy isn’t life threatening, but it can affect body image, self-esteem, and overall quality of life. Treatments are available to help manage these changes.

HIV-associated lipodystrophy can cause a few different patterns of fat changes:

  • Lipoatrophy: The loss of fat, often visible in your face (especially your cheeks), arms, legs, or buttocks.
  • Lipohypertrophy: A buildup of fat, usually around your abdominal area, breasts, the back of your neck (sometimes called a “buffalo hump”), or deep inside your abdomen around organs.
  • Mixed patterns: Some people experience fat loss and buildup at the same time but in different areas of their bodies.

Besides visible changes, lipodystrophy can also affect cholesterol, blood sugar levels, and insulin resistance, increasing the chance of cardiovascular conditions.

Several factors can contribute to lipodystrophy in people with HIV:

  • Older antiretroviral medications: Earlier HIV medications strongly link to fat changes.
  • HIV itself: The virus can cause long-term inflammation, which may affect how your body stores or uses fat.
  • Genetics: Some people may be more likely to develop lipodystrophy based on inherited traits.
  • Age and body weight: Older ages and higher body weights before starting HIV treatment may also increase the chance of HIV-associated lipodystrophy.

Since newer ART medications have fewer links to lipodystrophy, switching medications is sometimes part of managing the condition.

There’s no single test to diagnose HIV-associated lipodystrophy. Instead, a healthcare team may usually:

  • Ask about your symptoms: You might notice changes like clothes fitting differently or new lumps of fat.
  • Do a physical exam: Doctors might measure your waist, check for fat loss in your face and limbs, or assess other visible changes.
  • Order blood tests:These tests can help doctors check for changes in cholesterol, triglycerides, and blood sugar that sometimes accompany lipodystrophy.

It’s important to talk with a healthcare team if you notice any changes, even if they seem small.

Treatment for HIV-associated lipodystrophy focuses on managing symptoms and improving quality of life.

Options may include:

  • Switching medications: If your current HIV treatment contributes to fat changes, doctors might suggest switching to a newer option.
  • Medications: Certain drugs, like tesamorelin (Egrifta), have Food and Drug Administration (FDA) approval to help reduce fat buildup in your abdomen.
  • Lifestyle changes: A balanced diet and regular exercise can help manage fat distribution and reduce cardiovascular risks.
  • Cosmetic treatments: Fillers or facial implants can help restore lost volume in your cheeks or other areas affected by lipoatrophy.
  • Surgery: Doctors may consider liposuction or other surgical options for people with severe fat buildup.

Mental health support can also be important, especially if body image changes affect your confidence or emotional well-being.

HIV-associated lipodystrophy can cause noticeable changes in fat distribution, but it’s less common today, thanks to newer HIV treatments.

If you have HIV and notice any changes in your body, it’s important to bring them up with your healthcare team. Early support and treatment options can help manage the physical and emotional effects.

With the right care, many people can feel more confident and maintain their overall health.