Clinically significant incidental findings among human immunodeficiency virus-infected men during computed tomography for determination of coronary artery calcium
Nancy Crum-Cianflone, James Stepenosky, Sheila Medina, Dylan Wessman, David Krause, Gilbert Boswell, Nancy Crum-Cianflone, James Stepenosky, Sheila Medina, Dylan Wessman, David Krause, Gilbert Boswell
Abstract
Those infected with the human immunodeficiency virus (HIV) have a greater risk of cardiovascular disease and might undergo computed tomographic (CT) scans for early detection. Incidental findings on cardiac CT imaging are important components of the benefits and costs of testing. We determined the prevalence and factors associated with incidental findings on CT scans performed to screen for coronary artery calcium (CAC) among HIV-infected men. A clinically significant finding was defined as requiring additional workup or a medical referral. A total of 215 HIV-infected men were evaluated. Their median age was 43 years; 17% were current tobacco users; the median CD4 count was 580 cells/mm(3); and 83% were receiving antiretroviral medications. Also, 34% had a positive CAC score of >0. An incidental finding was noted among 93 participants (43%), with 36 (17%) having ≥1 clinically significant finding. A total of 139 findings were noted, most commonly pulmonary nodules, followed by granulomas, scarring, and hilar adenopathy. Most of the incidental findings were stable on follow-up, and no malignancies were detected. The factors associated with the presence of an incidental finding in the multivariate model included increasing age (odds ratio 1.6 per 10 years, p <0.01), positive CAC score (odds ratio 2.3, p <0.01), and current tobacco use (odds ratio 2.5, p = 0.02). In conclusion, incidental findings were common among HIV-infected men undergoing screening CT imaging for CAC determination. The incidental findings were more common among older patients and those with detectable CAC.
Conflict of interest statement
Conflict of Interest: None: The authors have no financial interest in this work or the vaccine evaluated in this clinical trial. All authors contributed to the content of the manuscript and concurred with the decision to submit it for publication.
Copyright © 2011 Elsevier Inc. All rights reserved.
Source: PubMed