van der Ven A, Bleeker-Rovers CP, Zomer B, Koopmans P, de Geus-Oei LF, Oyen WJ; International Conference on AIDS (15th : 2004 : Bangkok, Thailand).
Int Conf AIDS. 2004 Jul 11-16; 15: abstract no. B10816.
Department of Internal Medicine, University Medical Center Nijmegen, Nijmegen, Netherlands
Background: Lipodystrophy, an important complication of HAART, is a clinical diagnosis with early features often presenting 12-16 months after initiation of therapy. One hypothesis is that the pro-inflammatory response to HAART causes subcutaneous inflammation resulting in lipodystrophy. Since F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) also depicts inflammation, subcutaneous FDG-uptake on PET was studied in lipodystrophy patients. Methods: In a prospective study FDG-PET was performed in 4 patients treated with HAART for a maximum of 3 years with early features of lipodystrophy (all fulfilling the clinical definition), in 4 HIV-infected patients never treated with HAART (control 1) and in 4 HIV-infected patients without lipodystrophy treated with HAART for a maximum of 3 years (control 2). Whole body PET scanning was performed using a fullring camera. PET images were reconstructed with segmented attenuation correction. Subcutaneous FDG-uptake was classified as absent (score 0), slightly increased (score 1) or markedly increased (score 2) by two nuclear medicine specialists. Results: Median duration of HAART was 27 months in lipodystrophy patients and 24 months in control group 2. Subcutaneous FDG-uptake was markedly increased in 3 lipodystrophy patients and slightly increased in one. In control group 1, subcutaneous FDG-uptake was slightly increased in 2 cases and absent in 2. In control group 2, subcutaneous FDG-uptake was slightly increased in one case and absent in 3. Conclusions: Markedly increased subcutaneous FDG-uptake in 3 out of 4 HIV-infected patients with lipodystrophy and absence of this phenomenon in HIV-infected controls without lipodystrophy supports the hypothesis that lipodystrophy could be caused by subcutaneous inflammation in response to HAART. In addition, markedly increased subcutaneous FDG-uptake on PET scanning appears to be an objective early marker of the lipodystrophy syndrome.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Antiretroviral Therapy, Highly Active
- Control Groups
- Disease Progression
- Early Diagnosis
- HIV Infections
- HIV Seropositivity
- HIV-Associated Lipodystrophy Syndrome
- Humans
- Inflammation
- Lipodystrophy
- Positron-Emission Tomography
- Prospective Studies
- radionuclide imaging
Other ID:
UI: 102276536
From Meeting Abstracts