Incidental lung cancers and positive computed tomography images in people living with HIV
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Incidental lung cancers and positive computed tomography images in people living with HIV. / Ronit, Andreas; Kristensen, Thomas; Klitbo, Ditte M.; Gelpi, Marco; Kalhauge, Anna; Benfield, Thomas; Gerstoft, Jan; Lundgren, Jens; Vestbo, Jørgen; Kofoed, Klaus F.; Nielsen, Susanne D.
I: AIDS, Bind 31, Nr. 14, 09.2017, s. 1973-1977.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Incidental lung cancers and positive computed tomography images in people living with HIV
AU - Ronit, Andreas
AU - Kristensen, Thomas
AU - Klitbo, Ditte M.
AU - Gelpi, Marco
AU - Kalhauge, Anna
AU - Benfield, Thomas
AU - Gerstoft, Jan
AU - Lundgren, Jens
AU - Vestbo, Jørgen
AU - Kofoed, Klaus F.
AU - Nielsen, Susanne D.
PY - 2017/9
Y1 - 2017/9
N2 - Objective: Lung cancer screening with low-dose computed tomography (LDCT) of high-risk groups in the general population is recommended by several authorities. This may not be feasible in people living with HIV (PLWHIV) due to higher prevalence of nodules. We therefore assessed the prevalence of positive computed tomography (CT) images and lung cancers in PLWHIV. Design: The Copenhagen comorbidity in HIV infection (COCOMO) study is an observational, longitudinal cohort study. Single-round LDCT was performed with subsequent clinical follow-up (NCT02382822). Method: Outcomes included histology-proven lung cancer identified by LDCT and positive CT images (noncalcified nodules) in the entire cohort and in the high-risk group (>50 years of age and >30 pack-years). We also assessed the procedures and adverse events, and clinical factors associated with a positive CT image. Results: LDCT was performed in 901 patients, including 113 at high risk for lung cancer. A positive image was found in 28 (3.1% of the entire cohort and 9.7% of the high-risk group). Nine patients (all in the high-risk group) had invasive procedures undertaken with no serious adverse events. Lung cancer (stages IA, IIA, and IIIA) was diagnosed in three patients from the high-risk group (2.7%). CD4 + cell count less than 500 cells/μl and CD4 + nadir less than 200 cells/μl were each independently associated with increased odds of a positive image odds ratio 2.32 [95% confidence interval: 1.01-5.13, P==0.04] and odds ratio 2.63 [95% confidence interval: 1.13-6.66, P==0.03]. Conclusion: Randomized LDCT screening trials in PLWHIV are nonexistent, but these findings are comparable with screening rounds from the general population in terms of prevalence of lung cancer and positive CT images.
AB - Objective: Lung cancer screening with low-dose computed tomography (LDCT) of high-risk groups in the general population is recommended by several authorities. This may not be feasible in people living with HIV (PLWHIV) due to higher prevalence of nodules. We therefore assessed the prevalence of positive computed tomography (CT) images and lung cancers in PLWHIV. Design: The Copenhagen comorbidity in HIV infection (COCOMO) study is an observational, longitudinal cohort study. Single-round LDCT was performed with subsequent clinical follow-up (NCT02382822). Method: Outcomes included histology-proven lung cancer identified by LDCT and positive CT images (noncalcified nodules) in the entire cohort and in the high-risk group (>50 years of age and >30 pack-years). We also assessed the procedures and adverse events, and clinical factors associated with a positive CT image. Results: LDCT was performed in 901 patients, including 113 at high risk for lung cancer. A positive image was found in 28 (3.1% of the entire cohort and 9.7% of the high-risk group). Nine patients (all in the high-risk group) had invasive procedures undertaken with no serious adverse events. Lung cancer (stages IA, IIA, and IIIA) was diagnosed in three patients from the high-risk group (2.7%). CD4 + cell count less than 500 cells/μl and CD4 + nadir less than 200 cells/μl were each independently associated with increased odds of a positive image odds ratio 2.32 [95% confidence interval: 1.01-5.13, P==0.04] and odds ratio 2.63 [95% confidence interval: 1.13-6.66, P==0.03]. Conclusion: Randomized LDCT screening trials in PLWHIV are nonexistent, but these findings are comparable with screening rounds from the general population in terms of prevalence of lung cancer and positive CT images.
KW - computed tomography
KW - HIV
KW - incidental findings
KW - lung cancer
KW - nodules
U2 - 10.1097/QAD.0000000000001600
DO - 10.1097/QAD.0000000000001600
M3 - Journal article
C2 - 28857778
AN - SCOPUS:85028726138
VL - 31
SP - 1973
EP - 1977
JO - AIDS
JF - AIDS
SN - 1350-2840
IS - 14
ER -
ID: 189618637