Objective: To evaluate differences in glucose uptake by skeletal muscle tissue and subcutaneous fat in HIV patients on highly active antiretroviral therapy (HAART) presenting with and without lipodystrophy as well as in drug-naive HIV patients using 18F-fluorodeoxyglucose (FDG) positron emission tomography.
Patients and methods: Thirty-nine consecutive patients suffering from HIV: seven drug-naive patients, 21 nonlipodystrophic patients on HAART and 11 patients on HAART, respectively, suffering from lipodystrophy were prospectively included. All patients underwent a whole-body FDG positron emission tomography examination. Standardized uptake values (SUV values) of muscle and subcutaneous fat were compared and related to demographic and biochemical variables.
Results: SUV mean values of subcutaneous fat were significantly higher in patients under HAART presenting with lipodystrophy when compared with untreated and treated, nonlipodystrophic patients (P=0.000). SUV mean values of subcutaneous fat significantly correlated with treatment duration (r=0.56, P=0.000) and CD4 count (r=0.51, P=0.001) and inversely correlated with viral load (r=−0.61, P=0.000). Finally, SUV mean values of thigh muscles were not significantly different between the three different patient groups under study.
Conclusion: Quantitative FDG uptake by subcutaneous fat proved significantly higher in HIV patients under HAART presenting with lipodystrophy. HAART did not influence FDG uptake by human skeletal muscle tissue under basal conditions.
Departments of aNuclear Medicine
bInfectious Diseases, University of Pretoria
cDepartment of Internal Medicine, Louis Pasteur Hospital, Pretoria, South Africa
dDepartment of Nuclear Medicine, AZ Groeninge, Kortrijk
eDepartment of Morphology and Medical Imaging, University Hospital Leuven, Leuven
fDepartment of Nuclear Medicine, University Hospital Ghent, Ghent, Belgium
Correspondence to Dr Mike Sathekge, MD, Department of Nuclear Medicine, Pretoria Academic Hospital, University of Pretoria, Private Bag X169, Pretoria 0001, South Africa
Tel: +27 123541794; fax: +27 123541219;
Received 5 June 2009 Revised 13 November 2009 Accepted 14 November 2009