HIV, HAART, or a combination of virus and drug can present with a hollowing of certain parts of the face, with secondary accumulation of fat on the upper back (dorsocervical fat pad) and under the chin. This process has become known as HIV lipodystrophy. Some reports show an incidence of 2-60% in HIV patients taking protease inhibitors, while one study with a 5 year retrospective cohort showed a lipodystrophy prevalence of 13% in HIV positives taking protease inhibitors. Recent studies show that there is not a great difference between the different protease inhibitors when it comes to lipodystrophy, while previous studies indicated ritonavir/saquinavir as more commonly associated with HIV lipodystrophy. The median time to develop HIV lipodystrophy from time of starting protease inhibitors is 18 months.

The treatment of HIV lipodystrophy includes:

• Switching to another drug cocktail
• Diet changes
• Fillers
  •        Sculptra
  •        Restylane
  •        Fat
• Face lift

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