title: Incidental findings on chest computed tomography are common and linked to inflammation in HIV-infected adults.
abstract: Chest imaging is performed for a variety of reasons in HIV-infected adults. There are limited data on the prevalence of incidental findings, progression of these findings over time and the relationship with inflammation in antiretroviral therapy (ART)-treated HIV-infected adults.
  
  
  
  This study utilized data from a randomized clinical trial of rosuvastatin in HIV-infected adults on ART. Incidental findings were reported from chest computed tomography (CT) scans obtained for coronary artery calcium score at entry, week 48 and 96. Markers of immune activation and inflammation were measured concurrently. Poisson regression and generalized estimating equations were used.
  
  
  
  A total of 147 participants were enrolled. Median age was 46 years, 78% were male, 68% African American and 63% current smokers. At baseline, 57% of participants had at least one incidental lung finding (ILF) and four additional participants had at least one ILF by week 96. At baseline, older age, current smoking, lower nadir CD4+T-cell count and low-density lipoprotein and higher lipoprotein-associated phospholipase A2 (Lp-PLA2) were independently associated with having a greater number of ILFs. In the longitudinal analyses, older age, lower nadir CD4+T-cell count and higher baseline soluble tumour necrosis factor α-receptor I (sTNF-RI) were independently associated with having a greater number of ILFs over 96 weeks.
  
  
  
  Over half of participants had at least one incidental finding on chest CT. Beyond traditional factors of older age and smoking, lower nadir CD4+T-cell count and higher markers of inflammation were associated with having a greater number of ILFs in HIV-infected adults on ART.
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: Michelle S
authors.initials: MS
authors.lastname: Park
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, USA.|MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Corrilynn O
authors.initials: CO
authors.lastname: Hileman
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, USA.
authors.forename: Abdus
authors.initials: A
authors.lastname: Sattar
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, USA.|MetroHealth Medical Center, Cleveland, OH, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Gilkeson
authors.affiliation: Case Western Reserve University School of Medicine, Cleveland, OH, USA.|University Hospitals Case Medical Center, Cleveland, OH, USA.
authors.forename: Grace A
authors.initials: GA
authors.lastname: McComsey
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood; D000328:Adult; D000367:Age Factors; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D015658:HIV Infections / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000502:physiology; D006801:Humans; D033162:Incidental Findings; D008077:Lipoproteins, LDL / Q000097:blood; D008168:Lung / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D047888:Receptors, Tumor Necrosis Factor, Type I / Q000097:blood; D012307:Risk Factors; D000068718:Rosuvastatin Calcium / Q000627:therapeutic use; D012907:Smoking / Q000503:physiopathology; D014057:Tomography, X-Ray Computed
chemical_list: D000924:Anticholesteremic Agents; D008077:Lipoproteins, LDL; D047888:Receptors, Tumor Necrosis Factor, Type I; D000068718:Rosuvastatin Calcium; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase; C526684:PLA2G7 protein, human