FDG-PET imaging in HIV-infected subjects: relation with therapy and immunovirological variables

Abstract

The emergence, in our study, of a correlation between the percentage of CD8+/CD38+/RO+ T cells (well established markers of progression to AIDS independently of CD4+ T lymphocytes) and positive FDG-PET in ART-naive patients is a novel finding that seems to confer prognostic value on FDG uptake. FDG uptake is strongly associated with response to ART independently of a previous AIDS diagnosis. Notably, no differences were observed between ART-treated subjects classed as immunological responders and those classed as non responders. Data herewith indicate that FDG uptake and immunological variables are unrelated when ART is being administered. This is evidence of the complementarity of immunological and FDG measures. FDG uptake is a sensitive marker of disease state and its relation with CD8+/CD38+/CD45RO+ T cells indicates that it can be considered a marker of disease status. The lack of a correlation between FDG uptake and immunological variables in patients under ART warrants further investigation.

EANM/SNMMI Guideline for18F-FDG Use in Inflammation and Infection

“…• AIDS-associated opportunistic infections, associated tumors, and Castleman disease (72)(73)(74)(75)(76)(77)(78)(79)(80)(81)(82)(83).…”

FDG-PET Imaging in HIV Infection and Tuberculosis

“…This could reflect massive stimulation of B cells in the spleen by nonreplicating antigenic material. 34,35 More recently, Lucignani et al 36 assessed whether HIVinfected patients can be differentiated on the basis of the detection of specific locations of viral replication, even in the presence of an apparently optimal immunovirological response to HAART and whether FDG-PET findings can be related to immunovirological variables and AIDS history status. Patients under study were divided into 5 groups: subgroup A1 (full responders, n ¼ 8): current HAART treatment, CD4 þ T lymphocytes 4500 mL…”

“…In the HAART-naïve subjects, FDG uptake, apparently related to viremia level, was observed in the upper torso mainly in the axillary nodes bilaterally in patients with viremia below 100,000 copies/mL; in those with viremia higher than 100,000 copies/mL, FDG uptake was also observed in the inguinal LNs. 36 FDG-PET constitutes an in vivo, noninvasive imaging technique for disease state and its relation with immunovirological status indicates that it can be considered a marker of disease status.…”

Rol del PET/CT con 18FDG en patología no neoplásica

“…Se puede observar también con frecuencia un aumento de la captación esplénica, la que puede llegar a ser mayor que la hepática 40 . En pacientes sin tratamiento se ha encontrado una alta correlación entre viremia y número e intensidad de áreas de captación en el PET/CT 41 . Esta relación se pierde luego del inicio de la terapia antirretroviral, ya que suele observarse disminución del tamaño y del número de áreas de captación 42 .…”