Positron emission tomography in patients suffering from HIV-1 infection

  • Mike Sathekge
  • Ingeborg Goethals
  • Alex Maes
  • Christophe van de Wiele
Review article

DOI: 10.1007/s00259-009-1126-9

Cite this article as:
Sathekge, M., Goethals, I., Maes, A. et al. Eur J Nucl Med Mol Imaging (2009) 36: 1176. doi:10.1007/s00259-009-1126-9

Abstract

This paper reviews currently available PET studies performed either to improve our understanding of the pathogenesis of HIV-1 infection or to assess the value of PET imaging in the clinical decision making of patients infected with HIV-1 presenting with AIDS-related opportunistic infections and malignancies. FDG PET has shown that HIV-1 infection progresses by distinct anatomical steps, with involvement of the upper torso preceding involvement of the lower part of the torso, and that the degree of FDG uptake relates to viral load. The former finding suggests that lymphoid tissues are engaged in a predictable sequence and that diffusible mediators of activation might be important targets for vaccine or therapeutic intervention strategies. In lipodystrophic HIV-infected patients, limited available data support the hypothesis that stavudine-related lipodystrophy is associated with increased glucose uptake by adipose tissue as a result of the metabolic stress of adipose tissue in response to highly active antiretroviral treatment (HAART). Finally, in early AIDS-related dementia complex (ADC), striatal hypermetabolism is observed, whereas progressive ADC is characterized by a decrease in subcortical and cortical metabolism. In the clinical setting, PET has been shown to allow the differentiation of AIDS-related opportunistic infections and malignancies, and to allow monitoring of side effects of HAART. However, in patients suffering from HIV infection and presenting with extracerebral lymphoma or other human malignancies, knowledge of viraemia is essential when interpreting FDG PET imaging.

Keywords

HIV infection AIDS PET 

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Mike Sathekge
    • 1
  • Ingeborg Goethals
    • 2
  • Alex Maes
    • 3
  • Christophe van de Wiele
    • 2
  1. 1.Department of Nuclear MedicineUniversity Hospital of PretoriaPretoriaSouth Africa
  2. 2.Department of Nuclear MedicineUniversity Hospital GhentGhentBelgium
  3. 3.Department of Nuclear MedicineAZ GroeningKortrijkBelgium