Arterial inflammation in young patients with human immunodeficiency virus infection: A cross-sectional study using F-18 FDG PET/CT

J Nucl Cardiol. 2019 Aug;26(4):1258-1265. doi: 10.1007/s12350-018-1207-x. Epub 2018 Feb 7.

Abstract

Background: HIV infection is associated with the risk of development of atherosclerosis at a younger age. We compared arterial inflammation in HIV-infected and HIV-uninfected patients with otherwise low-risk factors for cardiovascular disease (CVD) using FDG PET/CT.

Methods: 242 patients aged 18-40 years with low-risk factors for CVD consisting of 121 HIV-infected patients and 121 HIV-uninfected age- and gender-matched controls were studied, mean age = 34.95 ± 5.46 years. We calculated and compared the target-to-background ratio of FDG uptake in ascending aorta of HIV-infected and non-infected patients.

Results: Median CD4 count and viral load were 375.5 cells/mm3 (range 2-1094) and 6391.00 copies/mL (range 24-1,348,622), respectively. There was slightly higher but significant overlap in the TBR between HIV-infected group compared with control (1.22, 0.87-2.02 vs. 1.12, 0.38-1.40, P < 0.001). TBR was neither affected by CD4 count levels nor the presence or absence of detectable viremia. We also found no significant difference in TBR between male and female patients with HIV infection. We found a weak positive correlation between TBR and CD4 count, TBR and duration of HIV infection, and a very weak negative correlation between TBR and viral load. There was no significant difference in TBR between patients on HAART and those not yet commenced on therapy.

Conclusion: Marginally higher TBR with a significant overlap exist in HIV-infected patients compared with control. Arterial F-18 FDG uptake is not affected by the CD 4 count, viral load, gender, or duration of HIV infection.

Keywords: FDG; HIV; PET/CT; cardiovascular disease; inflammation.

MeSH terms

  • Adolescent
  • Adult
  • Aorta*
  • Arteritis / diagnostic imaging*
  • Arteritis / virology*
  • Cross-Sectional Studies
  • Female
  • Fluorodeoxyglucose F18
  • HIV Infections / complications*
  • HIV Infections / diagnostic imaging*
  • Humans
  • Male
  • Positron Emission Tomography Computed Tomography*
  • Radiopharmaceuticals
  • Young Adult

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18