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There is a lack of objective tools to reliably diagnose exacerbations in bronchiectasis. The primary aim of this study was to assess the ability of fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) to detect sites of active inflammation in children with human immunodeficiency virus (HIV)-related bronchiectasis with or without exacerbations. The secondary aim was to assess whether 18F-FDG-PET/CT results are in agreement with local and systemic inflammatory markers and markers of HIV disease activity. Forty-one children with HIV-related bronchiectasis underwent 18F-FDG PET/CT. Data on the presence of a clinical exacerbation were recorded. Serum was collected for CD4 count, HIV viral load, C-reactive protein (CRP) and cytokines IL-8, INF-γ and TNF-α. Induced sputum samples were processed for microbiological culture and for IL-8, INF-γ and TNF-α. Mean age of all children was 8.2±2.2 years. Twelve subjects showed 18F-FDG lung uptake while six of them had an exacerbation. There was no difference in the 18F-FDG uptake in participants with or without an exacerbation (P=0.613). Fluorine-18-FDG-PET had a good correlation with the presence of consolidation (P=0.01, OR=6.67). The mean CRP was higher in the subjects with 18F-FDG uptake when compared to those without uptake (51.96±95.12 vs. 13.26±19.87), although this difference was not significant (P=0.09). In conclusion