Localization of infection in HIV antibody positive patients with fever. Comparison of the efficacy of Ga-67 citrate and radiolabeled human IgG.
Patients who are human immunodeficiency virus (HIV) antibody positive are at increased risk of life threatening infection. Scintigraphic imaging with Ga-67 citrate has been used to identify the presence and site of focal infection. However, focal accumulation of Ga-67 is not specific for infection. A retrospective study was performed to compare the accuracy of Ga-67 citrate and pooled human polyclonal immunoglobulin G (HIG) labeled with Tc-99m HIG and In-111 HIG in identifying infection in HIV antibody positive patients. Twenty-five studies were performed using Ga-67 and Tc-99m HIG were compared with a second group of 25 studies using In-111 HIG in HIV antibody positive patients presenting with fever, but without localizing symptoms or signs. In-111 HIG identified 20 of 22 sites of infection and also accumulated in 5 sites without infection (accuracy = 90%). This was significantly more accurate (X2, P < 0.05) than Ga-67 which identified 19 of 20 sites of infection, but accumulated in 18 sites without infection (accuracy = 74%) and Tc-99m HIG which identified infection in 11 of 20 sites, but accumulated in 8 sites without infection (accuracy = 77%). There was no significant difference between the accuracy of Ga-67 and Tc-99m HIG. From this preliminary study In-111 HIG would seem to be the best agent for identifying infection in HIV antibody positive patients with fever.
Buscombe
J R
JR
Institute of Nuclear Medicine, University College London Medical School, United Kingdom.
Oyen
W J
WJ
Corstens
F H
FH
Ell
P J
PJ
Miller
R F
RF
D017088:AIDS-Related Opportunistic Infections / Q000000981:diagnostic imaging*; D000293:Adolescent; D000328:Adult; D002951:Citrates; D019343:Citric Acid; D005334:Fever / Q000150:complications*; D005490:Focal Infection / Q000000981:diagnostic imaging; D005710:Gallium Radioisotopes; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D007136:Immunoglobulins; D007205:Indium Radioisotopes; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013667:Technetium
D002951:Citrates; D005710:Gallium Radioisotopes; D007136:Immunoglobulins; D007205:Indium Radioisotopes; C065376:technetium Tc 99m immunoglobulin; D019343:Citric Acid; D013667:Technetium