People with HIV have always shown a flair for language that describes their experience of the disease, and lipoatrophy is no exception. The following glossary includes the key street slang as well as the technical terms favored by the folks in the white lab coats:
Lipoatrophy: The condition in which the body's fat ("lipo-") cells are destroyed or disabled ("-atrophy"). Believed to be caused by the use of the HIV drugs d4T (stavudine, Zerit), AZT (zidovudine, Retrovir) ddI (didanosine, Videx) and possibly by other factors, including aging and HIV itself.
Facial Wasting: The loss of fat in the face, especially the cheeks and the temples, characterizing lipoatrophy.
Puppet Face: The street term for a severe case of facial lipoatrophy in which the cheeks and temples are hollowed out, resulting in puppetlike wrinkles and folds.
Mitochondrial Toxicity: Believed to be the cause of lipoatrophy. The mitochondria are tiny factories in your body's cells that convert nutrients, such as sugars and fats, into energy. By blocking an enzyme that mitochondria in fat cells need in order to reproduce, the three meds ddI, AZT and ddI cause the cell's mitochondria to fail, cutting off the cell's energy source and eventually its capacity to function.
Lipohypertrophy: The opposite of lipoatrophy, this condition is characterized by the accumulation of fat in the belly ("protease paunch"), the neck and upper back ("buffalo hump") and, in women, the breasts.
AIDS Wasting Syndrome: This condition is often confused with peripheral lipoatrophy, but is in fact very different. Wasting is characterized by the loss of fat and muscle (not just fat) all over the body (not just the face, limbs or butt). In addition, it is a symptom of advanced HIV disease and rarely afflicts people for whom treatment is controlling viral load and restoring immune function.
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