15 February 2020 by Puja Kohli

PET Imaging Reveals Early Pulmonary Perfusion Abnormalities in HIV Infection Similar to Smoking

RATIONALE
COPD is the most common non-infectious pulmonary disease among people living with HIV, independent of smoking. However, the cause for this enhanced susceptibility remains unclear, and the effects of HIV on pulmonary perfusion are unknown.

METHODS
We used PET-CT in 46 smokers and non-smokers, 23 of whom had with documented HIV infection. Emphysema was assessed by CT and perfusion by nitrogen-13 (13NN) PET scans. After removal of image noise, vertical and axial gradients in perfusion were calculated. We tested for differences in the total spatial heterogeneity of perfusion (CV2Qtotal) and its components
(CV2Qtotal = CV2Qvgrad (vertical gradient) + CV2Qzgrad (axial gradient) + CV2Qr (residual heterogeneity)) among groups.

RESULTS
There were no significant differences in demographic parameters among groups, and all subjects had minimal radiographic evidence of emphysema. Compared to controls, non-smokers living with HIV had a significantly greater CV2 Qr/ CV2Qtotal (0.48 vs 0.36, p = 0.05) and reduced CV2Qvgrad/ CV2Qtotal (0.46 vs 0.65, p = 0.038). Smokers also had a reduced CV2Qvgrad/ CV2Qtotal, however, there was no significant difference in CV2Qvgrad/ CV2Qtotal between smokers living with and without HIV (0.39 vs 0.34, p = 0.58), despite a decreased vertical perfusion gradient (Qvgrad)
in smokers living with HIV.

CONCLUSIONS
In non-smokers living with well-controlled HIV and minimal radiographic emphysema, HIV infection contributes to pulmonary perfusion abnormalities similar to smokers. These data indicate the onset of subclinical pulmonary perfusion abnormalities that could herald the development of significant lung disease in these susceptible individuals.

About the author


profile picture of Puja Kohli

Puja Kohli

Instructor of Medicine

Harvard Medical School

United States

Key Contributors

Puja Kohli MD MMSc, Vanessa J Kelly PhD, Kathryn A Hibbert MD, BjÖrn Corleis PhD, Mamary Kone, Josalyn Cho MD , Doreen DeFaria-Yeh MD, Douglas S Kwon MD PhD, Benjamin Medoff MD, R Scott Harris MD, Tilo Winkler PhD Division of Pulmonary and Critical Care at Massachusetts General Hospital, Boston, MA Department of Medicine, Harvard Medical School, Boston, MA The Ragon Institute of MGH, MIT and Harvard, Cambridge, MA Department of Internal Medicine and Carver College of Medicine and The University of Iowa, Iowa City, IA Division of Cardiology, Massachusetts General Hospital, Boston, MA Division of Infectious Disease, Massachusetts General Hospital, Boston, MA Department of Anesthesia, Massachusetts General Hospital, Boston, MA


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