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. 2023 May 1;37(6):905-912.
doi: 10.1097/QAD.0000000000003485. Epub 2023 Jan 19.

A prospective 18 F-fluorodeoxyglucose positron emission tomography/computed tomography study of the neurometabolic effects in cocaine use and HIV infection

Ramya S Mamidi  1 , Cyrus Ayubcha  2 , Grant Rigney  2 , Jason Kirschner  3 , Oke Gerke  4 , Thomas J Werner  1 , Pablo Tebas  3 , Abass Alavi  1 , Mona-Elisabeth Revheim  5   6
Affiliations

A prospective 18 F-fluorodeoxyglucose positron emission tomography/computed tomography study of the neurometabolic effects in cocaine use and HIV infection

Ramya S Mamidi et al. AIDS. .

Abstract

Objectives: HIV affects 36 million people globally with prevalence decreasing due to antiretroviral therapy (ART) and social awareness; transmission occurs during substance use. Cocaine usage independently affects brain activity and may result in reduced ART adherence. This study evaluates brain glucose metabolism measured by 18 F-fluorodeoxyglucose positron emission tomography/computed tomography ( 18 F-FDG PET/CT) in cocaine users with HIV infection.

Design: Sixty-three participants were categorized into groups: 36 HIV infected (HIV+) and 27 non-HIV infected (HIV-) individuals. Each group was further split into cocaine users (CO+) and non-cocaine users (CO-). Of the HIV+, half were cocaine users and half were not. Of the HIV-, 14 were cocaine users and 13 were not. 18 F-FDG-PET and low dose CT scans were performed on all participants.

Methods: Brain glucose metabolism was evaluated by 18 F-FDG uptake in the whole brain, cortex, basal ganglia, and cerebellum 120 min after injection. ROVER software was used for image analysis and regions of interest masks were applied via an adaptive threshold system. ANOVA tests and t -tests were performed to assess the respective differences between the four groups.

Results: Generally, the HIV+/CO+ group (group A) displayed the lowest levels of uptake whereas the HIV-/CO- group (group D) showed the highest; the HIV+/CO- and HIV-/CO+ groups (groups B and C) showed intermediate levels of activity across the whole brain, cortex, basal ganglia, and cerebellum.

Conclusion: HIV infection and cocaine usage were independently associated with a decrease in brain glucose uptake as measured by 18 F-FDG PET/CT. When combined, positive HIV status and cocaine patients showed the most decreased 18 F-FDG uptake.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Fig. 1
Fig. 1
(a) 18F-FDG-PET uptake in the whole brain of a group A participants, history of cocaine abuse and HIV positive.
Fig. 2
Fig. 2
(a–d) SUVmax with standard deviation among the study groups per brain region. (e–h) SUVmean with standard deviation among the study groups per brain region.
See this image and copyright information in PMC

Comment in

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