Side Effects of HIV Medicines

Lipodystrophy is a condition that changes the way your body makes, uses, and stores fat. Lipodystrophy is also known as fat redistribution, in which the body abnormally takes fat from one region of the body and relocates it to another part of the body.

The way lipodystrophy affects each person can vary based on numerous factors, including gender. For example, women tend to have fat buildup (also called lipohypertrophy) that occurs:

• Around the organs in the belly
• On the back of the neck between the shoulders
• In the breasts

In contrast, men tend to have fat loss (also called lipoatrophy) that occurs:

• In the arms and legs
• Around the hips
• On the face

People with lipodystrophy often have other metabolic problems, including high cholesterol and insulin resistance, which can lead to diabetes. If untreated, metabolic problems caused by lipodystrophy can also lead to other conditions, such as heart disease.

While the exact cause of lipodystrophy remains unknown, it may be attributed to HIV. In addition, some HIV-related medicines could cause lipodystrophy, particularly after long-term use. Some HIV medicines that have been linked to lipodystrophy include atazanavir, darunavir, fosamprenavir, ritonavir, and tipranavir.

If you are currently taking any of these medicines and believe you are experiencing lipodystrophy, you should consult with your health care provider to determine if you need to adjust your treatment regimen. Do not stop taking your current HIV medicine unless your doctor advises you to do so.

Aside from HIV and HIV-related medicines, some evidence suggests an increased risk of lipodystrophy in people who are:

• Women
• Black
• Genetically predisposed
• Underweight or overweight
• Older

If you believe you are at an increased risk of lipodystrophy, it’s important to understand your treatment options.

If you have HIV and think you also have lipodystrophy, talk to your health care provider about treatment options, including potential changes to your HIV medicine. Never stop taking your HIV medicines without consulting your doctor. A health care provider could also prescribe non-HIV medicines to help treat lipodystrophy. 

Aside from changing medicines, the effects of lipodystrophy could be reduced through dietary changes and regular exercise. In other cases, liposuction (surgical fat removal) and injectable facial fillers are sometimes used to treat lipodystrophy.

From the NIH Office of AIDS Research: 

• Guidelines for the Use of Antiretroviral Agents in Pediatric HIV Infection:
  • Lipodystrophies and Weight Gain
• Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV: 
  • Adverse Effects of Antiretroviral Agents

From the Department of Veterans Affairs: 

• FAQ: Will HIV medicines cause changes to your fat and stomach?

From the New York State Department of Health

• Managing Side Effects of HIV Medications

From the Health Resources and Services Administration: 

• Guide for HIV/AIDS Clinical Care: Abnormalities of Body-Fat Distribution

Also see the HIV Source collection of HIV links and resources.