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

Esmail, Hanif; Lai, Rachel; Lesosky, Maia; Wilkinson, Katalin A.; Graham, Christine M.; Coussens, Anna K.; Oni, Tolu; Warwick, James; Said-Hartley, Qonita; Koegelenberg, Coenraad F. N.; Walzl, Gerhard; Flynn, JoAnne L.; Young, Douglas; Barry, Clifton E.; O’Garra, Anne; Wilkinson, Robert J.

doi:10.1038/nm.4161

Cited by 160 publications

(151 citation statements)

References 16 publications

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“…A recent study reported that among HIV co-infected individuals with LTBI, those with lung abnormalities on FDG-PET/CT (including infiltrates, fibrotic scars, or active nodules) were more likely to subsequently develop symptomatic active disease than those without [5]. Interestingly the two asymptomatic patients identified in our study (patients 1 and 2) had SUV max in the same range (2.7–3.9) as the three symptomatic patients (patients 3, 4, and 5) who had culturable TB (range 1.5–3.1), suggesting that these groups may be very close in the disease spectrum.…”

Section: Discussionmentioning

confidence: 99%

“…The radiotracer accumulates within inflammatory cells such as macrophages and neutrophils and can be quantified as a standardized uptake value (SUV). Previous reports have shown increased FDG-uptake in the lungs and lymph nodes of persons presumed to be recently infected with TB (household contacts of TB cases with a positive QuantiFERON-TB Gold) [4], in asymptomatic HIV co-infected individuals in a high TB burden setting [5], and in individuals with active TB lesions [6, 7]. FDG-uptake has variably risen or fallen in response to treatment [7].…”

Section: Introductionmentioning

confidence: 99%

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FDG-PET/CT activity leads to the diagnosis of unsuspected TB: a retrospective study

Geadas¹,

Acuña-Villaorduña²,

Mercier³

et al. 2018

BMC Res Notes

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ObjectiveMycobacterium tuberculosis infection leads to latent or active tuberculosis (TB). Increased uptake on 18F-fluoro-2-deoxy-glucose-positron emission tomography/computed tomography (FDG-PET/CT) has been reported in the lungs and lymph nodes of individuals with recent infection and active TB, but not in individuals without known recent exposure or suggestive symptoms. We describe five patients with lung nodules not suspected to be due to TB in whom abnormalities on FDG-PET/CT scans ultimately were attributed to TB infection.ResultsPatient records were searched using the words “positron emission tomography/computed tomography” and 24 codes for TB between 2004 and 2013. Patients with a diagnosis of TB and a PET/CT scan were included. Clinical and radiographic data were retrieved. PET/CT images were reviewed by an experienced radiologist. FDG-PET/CT scans revealed elevated FDG-uptake in lungs of five patients subsequently diagnosed with active (n = 3) or clinically inactive (n = 2) tuberculosis. Uptake magnitude was unrelated to disease activity. These findings suggest that tuberculosis latency may include periods of percolating inflammation of uncertain relationship to future disease risk.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

FDG-PET/CT activity leads to the diagnosis of unsuspected TB: a retrospective study

Geadas¹,

Acuña-Villaorduña²,

Mercier³

et al. 2018

BMC Res Notes

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“…A blood-based triage test that allows targeted investigation of individuals with active and sub-clinical TB disease, including asymptomatic individuals at highest risk of progression from latency to disease, could help to shorten the time to treatment start, or even prevent incipient disease before symptoms emerge. [6,7] The vision of a TB blood test to identify high-risk individuals for targeted preventive or curative therapy is within reach.…”

Section: Guest Editorialmentioning

confidence: 99%

A novel blood test for tuberculosis prevention and treatment

et al. 2016

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“…8 Transcriptional biomarkers and T-cell activation markers are showing promise, as are sophisticated imaging techniques such as positron emission tomography. 9–11 Better diagnostic and prognostic tools will enable targeted preventive therapy for those at high risk of disease progression.…”

Section: Introductionmentioning

confidence: 99%

Long-acting formulations for the treatment of latent tuberculous infection: opportunities and challenges

Swindells

Siccardi

Barrett

et al. 2018

int j tuberc lung dis

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SUMMARY Long-acting/extended release drug formulations have proved very successful in diverse areas of medicine including contraception, psychiatry, and most recently, HIV disease. While challenging, application of this technology to TB treatment could have substantial impact. The length of treatment required for all forms of TB put existing regimens at risk for failure because of early discontinuations and treatment default. Long-acting injections, for example administered monthly, could improve patient adherence and treatment outcomes. We review the state of the science for potential long-acting formulations of existing TB drugs, and propose a Target Product Profile for new formulations to treat latent TB infection. The physicochemical properties of some TB drugs make them unsuitable for long-acting formulation, but there are promising candidates that have been identified through modeling and simulation, and other novel agents and formulations in preclinical testing. An efficacious long-acting treatment for latent TB infection, particularly for those co-infected with HIV, and if coupled with a biomarker to target those at highest risk for disease progression, would be an important tool to accelerate progress towards TB elimination.

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

Cited by 160 publications

References 16 publications

FDG-PET/CT activity leads to the diagnosis of unsuspected TB: a retrospective study

FDG-PET/CT activity leads to the diagnosis of unsuspected TB: a retrospective study

A novel blood test for tuberculosis prevention and treatment

Long-acting formulations for the treatment of latent tuberculous infection: opportunities and challenges

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