Characterization of progressive HIV-associated tuberculosis using 2-deoxy-2-[18F]fluoro-D-glucose positron emission and computed tomography

• Published in: Nature medicine Vol. 22; no. 10; pp. 1090 - 1093
• Main Authors: Esmail, Hanif, Lai, Rachel P, Lesosky, Maia, Wilkinson, Katalin A, Graham, Christine M, Coussens, Anna K, Oni, Tolu, Warwick, James M, Said-Hartley, Qonita, Koegelenberg, Coenraad F, Walzl, Gerhard, Flynn, JoAnne L, Young, Douglas B, Barry III, Clifton E, O'Garra, Anne, Wilkinson, Robert J
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-10-2016; Nature Publishing Group
• Subjects: 14; 692/308/575; 692/420/254; 692/699/255/1856; 692/699/255/1901; 82/51; 82/80; 9/74; Abnormalities; Adult; Adults; Analysis; Antiretroviral agents; Biomarkers; Biomedicine; brief-communication; Cancer Research; Care and treatment; CAT scans; Coinfection - diagnostic imaging; Computation; Computed tomography; Disease Progression; Emissions; Female; Fluorodeoxyglucose F18; Glucose; Health aspects; HIV; HIV Infections - complications; HIV patients; Human immunodeficiency virus; Humans; Infectious Diseases; Interferon-gamma Release Tests; Latent infection; Latent Tuberculosis - complications; Latent Tuberculosis - diagnostic imaging; Male; Metabolic Diseases; Molecular Medicine; Mycobacterium tuberculosis - isolation & purification; Neurosciences; Positron emission; Positron Emission Tomography Computed Tomography; Radiography, Thoracic; Radiopharmaceuticals; South Africa; Sputum - microbiology; Tuberculosis; Tuberculosis - complications; Tuberculosis - diagnostic imaging; Tuberculosis, Pulmonary - complications; Tuberculosis, Pulmonary - diagnostic imaging
• ISSN: 1078-8956; 1546-170X
• DOI: 10.1038/nm.4161

By using combined positron emission and computed tomography (PET–CT), Esmail
et al.
show that some patients with latent tuberculosis have signs of subclinical, active disease in the lungs and a greater likelihood of progression, suggesting a spectrum of disease rather than discrete latent and active disease states.
Tuberculosis is classically divided into states of latent infection and active disease. Using combined positron emission and computed tomography in 35 asymptomatic, antiretroviral-therapy-naive, HIV-1-infected adults with latent tuberculosis, we identified ten individuals with pulmonary abnormalities suggestive of subclinical, active disease who were substantially more likely to progress to clinical disease. Our findings challenge the conventional two-state paradigm and may aid future identification of biomarkers that are predictive of progression.