In the current study, we have performed sEV miRNA profiling in this well-phenotyped cohort of individuals with and without HIV in whom we have previously characterized adipose expression of Dicer. We hypothesized a unique miRNA signature among those with HIV lipodystrophy in relationship to dysregulation of Dicer. In these analyses evaluating sEV miRNA profiles, we identified 3 specific miRNAs (miR-20a-3p, -186, and -324-3p) as the top differentially regulated miRNAs using a stringent statistical approach. Here, DICER1 is linked to lipodystrophy.