RT Journal Article SR Electronic T1 PET Imaging Reveals Early Pulmonary Perfusion Abnormalities in HIV Infection Similar to Smoking JF Journal of Nuclear Medicine JO J Nucl Med FD Society of Nuclear Medicine SP jnumed.120.245977 DO 10.2967/jnumed.120.245977 A1 Puja Kohli A1 Vanessa J. Kelly A1 Kathryn A. Hibbert A1 Björn Corleis A1 Mamary Kone A1 Josalyn L. Cho A1 Doreen Defaria-Yeh A1 Douglas S. Kwon A1 Benjamin D. Medoff A1 R. Scott Harris A1 Tilo Winkler YR 2020 UL http://jnm.snmjournals.org/content/early/2020/09/25/jnumed.120.245977.abstract AB 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 and ventilation are unknown. METHODS: We used PET-CT in 46 smokers and non-smokers, 23 of whom had 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. CONCLUSION: 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.