18 F-FDG-PET metabolic metrics and International Prognostic Score for risk assessment in HIV-infected patients with Hodgkin lymphoma Ismaheel O. Lawal a , Alfred O. Ankrah a,c , Gbenga O. Popoola d , Nozipho E. Nyakale b , Tebatso G. Boshomane a , Florette Reyneke a , Thabo Lengana a , Mariza Vorster a and Mike M. Sathekge a Objectives Baseline metabolic metrics on fluorine- 18-fluorodeoxyglucose PET ( 18 F-FDG PET) have prognostic value in Hodgkin lymphoma. International Prognostic Score (IPS) is used in the risk stratification of Hodgkin lymphoma. We compared the metabolic indices in HIV-infected and the IPS in HIV-infected and uninfected patients with Hodgkin lymphoma. Patients and methods We retrospectively reviewed the data of HIV-infected and HIV-uninfected patients with classic Hodgkin lymphoma who had 18 F-FDG PET for staging and compared the maximum standardized uptake value, mean standardized uptake value, metabolic tumor volume, and total lesion glycolysis between the two groups. We also compared the IPS and other prognostic indicators and correlated them with the metabolic indices in the two groups. Results We studied 160 patients, which included 57 patients who were infected with HIV. The mean age was 33.84 ± 11.88 years, with 38% (n = 61) being female. The median cluster of differentiation 4 count and HIV viral load were 259 cells/mm 3 and 4837.50 copies/ml, respectively. No significant difference in maximum standardized uptake value, mean standardized uptake value, metabolic tumor volume, and total lesion glycolysis between the two groups was found. Among the seven parameters of the IPS, only male sex (HIV-uninfected group higher, P = 0.005) and serum albumin less than 4 g/dl were significantly different. The other parameters were not significantly different between the two groups. Other prognostic indicators including bulky disease, extranodal involvement, and the number of nodal groups involved were not significantly different between the two groups. Conclusion There was no significant difference in 18 F-FDG metabolic parameters, IPS, and other risk indicators between HIV-infected and HIV-uninfected patients with Hodgkin lymphoma. Nucl Med Commun 39:1005–1012 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. Nuclear Medicine Communications 2018, 39:1005–1012 Keywords: HIV, Hodgkin lymphoma, International Prognostic Score, metabolic tumor volume, maximum standardized uptake value, mean standardized uptake value, total lesion glycolysis a Department of Nuclear Medicine, Steve Biko Academic Hospital, University of Pretoria, Pretoria, b Department of Nuclear Medicine, Inkosi Albert Lithuli Central Hospital, University of Kwa-Zulu Natal, Durban, South Africa, c Department Nuclear Medicine and Molecular Imaging, University Medical Centre, University of Groningen, Groningen, The Netherlands and d Department of Epidemiology and Community Health, University of Ilorin, Ilorin, Nigeria Correspondence to Mike M. Sathekge, MD, PhD, Department of Nuclear Medicine, Steve Biko Academic Hospital, University of Pretoria, Private Bag X169, Pretoria 0001, South Africa Tel: + 27 12 354 1794; fax: + 27 12 354 1219; e-mail: mike.sathekge@up.ac.za Received 23 May 2018 Revised 19 August 2018 Accepted 20 August 2018 Introduction HIV infection is a common cause of immune dysfunction across the world. Immunosuppression associated with HIV infection predisposes to opportunistic infections including infection with oncogenic viruses. Two cate- gories of HIV-associated cancers have been defined: AIDS-defining cancers and non-AIDS-defining cancers. Combination antiretroviral therapy (cART) is an effective treatment modality capable of suppressing viral replica- tion and restoring immune function in HIV-infected individuals. As of mid-2017, 20.9 million people living with HIV were already accessing cART, up from 17.1 million in 2015 and 7.7 million in 2010 [1]. This effective rollout of cART has led to significant reduction in the incidence of AIDS-defining cancers such as Kaposi sarcoma, non-Hodgkin lymphoma and cervical cancer [2–4]. Hodgkin lymphoma is one of the commonest non- AIDS-defining cancers. Its incidence as well as the inci- dences of other non-AIDS-defining cancers have not witnessed a similar decline as seen with AIDS-defining cancers [3–6]. Chemotherapy with or without involved-field radio- therapy is the preferred treatment for Hodgkin lym- phoma, with most patients achieving sustained cure [7,8]. These effective treatment modalities are associated with treatment-related adverse effects, some of which can be very serious including infertility, secondary malignancies, and treatment-related mortality [9]. Many trials have been done comparing different chemotherapy regimens Original article 0143-3636 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved. DOI: 10.1097/MNM.0000000000000905 Copyright r 2018 Wolters Kluwer Health, Inc. All rights reserved.