Historically, HIV disease has been associated with changes to body shape.

Prior to HIV treatments being widely available, people with advanced disease often developed what was called ‘HIV wasting syndrome’, which was associated with a rapidly ageing appearance and the loss of subcutaneous fat—most visible in the face. Plastic surgeons suggest that the loss of this subcutaneous fat in the face plays the biggest role in the normal ageing of the face.

In the late 1990s a number of people on treatments developed a syndrome known as ‘lypodystrophy syndrome’. This syndrome was particularly associated with lipoatrophy (the loss of fat in the face and the limbs). This pronounced lipoatrophy was shown to be particularly associated with some of the treatments used to treat HIV, particularly d4T (stavudine) and less commonly AZT (zidovudine) and ddI (didanosine).

HIV treatments that are most associated with lipoatrophy of the face and limbs are now rarely used. As a result the more severe effects of lipoatrophy are rarely seen in people who commenced treatment this century.