What Is HIV-Associated Lipodystrophy?

The Symptoms and Causes of Fat Redistribution in People With HIV

Lipodystrophy - "Buffalo hump"

Lipodystrophy is a syndrome in people with HIV that refers to a change in how body fat is distributed throughout the body—both inside and outside the body. Besides a change in appearance, lipodystrophy may also pose harmful health risks to a person. Let's gather a better understanding of what lipodystrophy looks like in a person with HIV, how it affects their health, and theories as to why it develops.

Symptoms of Lipodystrophy

At the Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) held in Toronto in 1997, scientists reported patients that had developed increased fat deposits around their abdomen and the back of the neck. They also found that these same patients had evidence of thinning arms, legs, and faces. The condition is now known as HIV-associated lipodystrophy.

The signs of lipodystrophy are well documented—a loss of fat in the arms, legs, buttocks, and face, and a gain of fat deposits in the neck ("buffalo hump"), breasts, and abdomen ("protease paunch"). Some patients also report smaller areas of fat deposits that appear as small soft lumps beneath the skin.

Symptoms of fat redistribution include back pain, especially in women who get extra fat in their breasts. Headaches and problems with breathing or sleeping may occur in people who develop a pronounced buffalo hump.

The increase of fat in a person's abdomen with lipodystrophy can make it feel hard and uncomfortable. This is most often due to the gathering of fat around internal organs like the intestines and pancreas, putting direct pressure that cause indigestion, discomfort and distress.

Some people with lipodystrophy experience an increase in fats in their bloodstream, as evidenced by an increased cholesterol level.

This increased cholesterol level may increase a person's risk of developing heart disease. Diabetes can also result from lipodystrophy due to impaired sugar processing in the body.

Who Gets Lipodystrophy?

While lipodystrophy appears in both men and women, men are more likely to experience a loss of fat in their arms and legs, and women are more likely to gain fat in their breasts and abdomen. There also seems to be a higher incidence of lipodystrophy in people with lower CD4 counts and in people who have had HIV for a long time. 

While the exact cause of lipodystrophy has not been empirically established (insofar as people are affected and others aren't), most scientists acknowledge that there is a strong connection between lipodystrophy and certain antiretroviral medications. Others theorize that lipodystrophy may be a complication related to long-term HIV infection, while other believe that it is a direct consequence of HIV viral activity.


AIDSI nfo. (2014). "Side Effects of HIV Medications: HIV and Lipodystrophy."

UCSF HIVInSite. (2011). "Body shape changes"

U.S. Food and Drug Administration (FDA). "FDA approves Egrifta to treat Lipodystrophy in HIV patients." Silver Spring, Maryland; press release issued November 10, 2010.

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