Application of a Novel CD206+ Macrophage-Specific Arterial Imaging Strategy in HIV-Infected Individuals

Background. The ability to noninvasively assess arterial CD206(+) macrophages may lead to improved understanding of human immunodeficiency virus (HIV)-associated cardiovascular disease. Methods. We trialed a novel macrophage-specific arterial imaging technique. Results. We demonstrated colocalization between technetium Tc 99m tilmanocept (Tc-99m-tilmanocept) and CD206(+) macrophages ex vivo. In vivo application of Tc-99m-tilmanocept single-photon emission computed tomography/computed tomography revealed high-level Tc-99m-tilmanocept uptake across 20.4% of the aortic surface volume among HIV-infected subjects, compared with 4.3% among non-HIV-infected subjects (P =.009). Among all subjects, aortic high-level Tc-99m-tilmanocept uptake was related to noncalcified aortic plaque volume (r = 0.87; P =.003) on computed tomographic angiography, and this relationship held when we controlled for HIV status. Conclusion. These first-in-human data introduce a novel macrophage-specific arterial imaging technique in HIV.