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Case Reports
. 2011 Nov-Dec;66(6):419-21.
doi: 10.2143/ACB.66.6.2062606.

High FDG uptake on FDG-PET scan in HIV-1 infected patient with advanced disease

L Belkhir  1 , S Jonckheere, R Lhommel, B Vandercam, J C Yombi
Affiliations
Case Reports

High FDG uptake on FDG-PET scan in HIV-1 infected patient with advanced disease

L Belkhir et al. Acta Clin Belg. 2011 Nov-Dec.

Abstract

We report the case of a 48-year-old Caucasian male positive for HIV-1 who was admitted in our clinic for a fever of unknown origin with weight loss. The CD4 cell count was 99/mm3 and the viral load (VL) was 836500 copies/ml. A first FDG-PET-CT showed abnormal hypermetabolism of multiple lymp nodes, of the bone marrow and of the spleen. Tuberculosis and lymphoma were excluded by a lymph node biopsy and a culture. Six months after the start of a highly active anti-retroviral therapy (HAART) containing lamuvidine, tenofovir, atazanavir boosted by ritonavir, a new FDG-PET-CT showed a complete normalisation of the metabolism in the regions previously described as having a high FDG uptake. The VL was < 37 copies/ml and his CD4 cell count was 399/mm3.

In conclusion: in patients with advanced HIV infections presenting with FUO, high uptake in 18FDG-PET-CT can be the marker of advanced disease reflecting the areas of viral replication.

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