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What is lipodystrophy?
Body fat changes in HIV are also known as lipodystrophy. Three patterns of body fat changes are being seen in people with HIV who are taking potent combinations of anti-HIV drugs (often called Highly Active Antiretroviral Therapy or HAART for short). These are:
- Gaining fat on the abdomen/belly (central fat), between the shoulder blades, or around the neck or in the breasts (mostly in women).
- Losing fat from under the skin which becomes most obvious in the arms, legs, buttocks and face, resulting in facial wasting, shrunken buttocks and prominent veins on the arms and legs. Only this particular kind of fat loss is specific to HIV infection. Fat gain may be caused by metabolic changes that also occur in HIV-negative people.
- A mixture of both fat gain and fat loss.
The fat gain is not sub-cutaneous fat (the squidgy fat directly under the skin). Central fat gain is within the abdomen. This makes the belly feel harder; some people have described it as feeling taut, like a football or like pregnancy. This fat accumulation may also interfere with food intake.
The majority of people who develop these changes experience a mixture of both types of body fat change. You may often hear these fat changes referred to as ‘fat redistribution’.
The body fat changes can be accompanied by metabolic changes (rises in levels of
fats and sugar in the blood).
A few people will also develop small, unusual fat deposits on other parts of the body, usually the limbs and trunk. These are called lipomas.