Incidental findings on coronary computed tomography angiography in Human Immunodeficiency Virus (HIV)-positive and HIV-negative persons. Open Forum Infectious Diseases
Reinschmidt et al. aimed to assess the prevalence and factors associated with incidental findings among HIV-positive and HIV-negative participants ≥45 years from the Metabolic&Aging study undergoing coronary computed tomography angiography (CCTA).
Findings were defined as incidental if not previously known. A finding was deemed to be significant if medical referral or radiological workup was recommended. A total of 553 persons, 341 with and 212 without HIV infection, were included in the study. Incidental findings were observed in 291 of 553 (53%) patients. In 42 of 553 (7.6%) participants, an incidental finding resulted in additional workup. A malignancy was diagnosed in 2 persons. In the HIV-positive group, age (1.31 per 5 years, 1.10–1.56) and smoking (2.29, 1.43–3.70) were associated with incidental findings; in the HIV-negative group, age (1.26, 1.01–1.59) and a coronary artery calcification score >0 (2.08, 1.09–4.02) were associated with incidental findings. HIV seropositivity did not affect the risk of incidental findings.
In sum, the study showed that CCTA, a promising imaging tool to diagnose subclinical atherosclerosis in patients with increased cardiovascular risk including HIV infection, was associated with a remarkable rate of incidental findings. These included clinically significant findings that had implications for patient care and were associated with significant additional expenses. However, HIV infection was not associated with an increased risk of incidental findings.