Gallium scintigraphy in AIDS

Gallium-67 scanning, indicated either for the elucidation of symptoms or for the assessment of appropriate therapy, was performed in 56 AIDS patients who underwent a total of 77 scans from 1986 to 1988. The age range of the patients was 13-66 years with an average age of 39 years. The majority of patients (95%) were male homosexuals. Gallium scanning has been applied to a wide spectrum of malignancies and to the detection of occult infections. Several mechanisms of uptake have been postulated for the localization of gallium. In general, gallium-67 acts as an analogue of the ferric ion, binding to transferrin soon after intravenous injection. It is believed that it is bound to transferrin receptors on the surface of tumour cells with subsequent intracellular transport. In infection, the association is probably with lactoferrin elaborated by polymorphonuclear cells and siderophores elaborated by bacteria. Gallium-67 is normally distributed to bone and bone marrow, liver, spleen, breast and bowel. In particular, the concentration in the ascending and transverse colon necessitates adequate bowel preparation. Lacrimal, nasopharyngeal and genital activity may also be seen. 11 refs., 2 tabs., 6 figs