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In this cross-sectional study, 145 HIV-positive patients on ART, 146 HIV-positive patients not on ART, and 72 HIV-negative individuals visiting the Namakkal District Head Quarters Hospital, Tamil Nadu, India, were recruited from February 2007 to April 2009. Among the patients on ART, the prevalence of lipodystrophy was 60.7%; 22.7% with lipohypertrophy, 51.1% with lipoatrophy, and 22.7% with mixed pattern. The proportion of patients with dyslipidemia was significantly higher in the treatment group when compared to ART-naive and HIV-negative controls ( P = .00). Total duration of ART was significantly associated with lipodystrophy ( P = .04) and dyslipidemia ( P = .01). Also, by logistic regression, abnormal metabolic levels were a risk factor in lipodystrophy ( P = .02). 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