Clinically significant extra-cardiac findings in asymptomatic HIV-positive men undergoing cardiac magnetic resonance imaging

Int J STD AIDS. 2015 Apr;26(5):346-51. doi: 10.1177/0956462414538005. Epub 2014 May 28.

Abstract

Increased research-based imaging has led to an increase in clinically significant extra-cardiac findings. HIV patients are at increased risk of having polypathology at a younger age; therefore, it may be hypothesised that they would have more incidental findings on imaging. We reviewed the magnetic resonance imaging results of 169 HIV-positive and 40 HIV-negative, clinically well volunteers undergoing cardiac magnetic resonance imaging scanning to assess the prevalence of subclinical cardiac pathology. This sub-study assessed the prevalence of clinically significant extra-cardiac findings. Associated risk factors were assessed and clinical follow-up and outcome were ascertained. Of the HIV-positive study group, 12/169 (7.1%) vs. 1/40 (2.5%) control patients had a clinically significant extra-cardiac finding which warranted further radiological or clinical intervention (p = 0.28). A total of three out of 169 (1.1%) were highly clinically significant findings. On logistic regression analysis, age was the only significant contributing factor (p = 0.049); no HIV-associated factors were found to be significant. The prevalence of clinically significant extra-cardiac findings of 7.1% in this HIV-positive cohort is comparable to the prevalence found in previous studies carried out on an older, sicker general population. This highlights the need for planning for unexpected outcomes and also the high rate of clinically significant findings in a seemingly well HIV-positive population.

Keywords: AIDS; Europe; HIV; MRI; cardiac magnetic resonance imaging; cardiovascular disease; extra-cardiac findings; incidentaloma; men.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use
  • Case-Control Studies
  • Female
  • HIV Infections / complications*
  • HIV Infections / drug therapy
  • Heart / physiopathology*
  • Humans
  • Incidental Findings
  • Magnetic Resonance Imaging, Cine / statistics & numerical data*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Regression Analysis
  • Risk Factors
  • Sensitivity and Specificity

Substances

  • Anti-Retroviral Agents