%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Thouvenin, Y.
%A Makinson, A.
%A Cournil, Amandine
%A Eymard-Duvernay, Sabrina
%A Lentz, P.
%A Delemazure, A. S.
%A Corneloup, O.
%A Fabre, S.
%A Quesnoy, Mylène
%A Poire, S.
%A Brillet, P. Y.
%A Cyteval, C.
%A Reynes, J.
%A Le Moing, V.
%T Chest low-dose computed tomography for early lung cancer diagnosis as an opportunity to diagnose vertebral fractures in HIV-infected smokers, an ANRS EP48 HIV CHEST substudy
%D 2015
%L fdi:010064765
%G ENG
%J Jaids.Journal of Acquired Immune Deficiency Syndromes
%@ 1525-4135
%K HIV ; vertebral fracture ; osteoporosis ; computed tomography ; smoking ; lung cancer
%M ISI:000356714600007
%N 3
%P 299-305
%R 10.1097/qai.0000000000000599
%U https://www.documentation.ird.fr/hor/fdi:010064765
%> https://www.documentation.ird.fr/intranet/publi/2015/07/010064765.pdf
%V 69
%W Horizon (IRD)
%X Background:To estimate the prevalence of vertebral fractures on chest low-dose computed tomography (LDCT) in HIV-infected smokers.Methods:Cross-sectional study of vertebral fractures visualized on chest LDCT from a multicenter prospective cohort evaluating feasibility of chest LDCT for early lung cancer diagnosis in HIV-infected subjects. Subjects were included if 40 years or older, had been active smokers within the last 3 years of at least 20 pack-years, and had a CD4 T-lymphocyte nadir cell count <350 per microliter and an actual CD4 T-cell count >100 cells per microliter. Spinal reconstructed sagittal planes obtained from chest axial native acquisitions were blindly read by a musculoskeletal imaging specialist. Assessment of the fractured vertebra used Genant semiquantitative method. The study end point was the prevalence of at least 1 vertebral fracture.Results:Three hundred ninety-seven subjects were included. Median age was 49.5 years, median smoking history was 30 pack-years, median last CD4 count was 584 cells per microliter, and median CD4 nadir count was 168 cells per microliter; 90% of subjects had a viral load below 50 copies per milliliter. At least 1 fracture was visible in 46 (11.6%) subjects. In multivariate analysis, smoking 40 packs-years [OR = 2.5; 95% CI: (1.2 to 5.0)] was associated with an increased risk of vertebral fracture, while HIV viral load <200 copies per milliliter [OR = 0.3; 95% CI: (0.1 to 0.9)] was protective.Conclusions:Prevalence of vertebral fractures on chest LDCT was 11.6% in this high-risk population. Smoking cessation and early introduction of antiretroviral therapy for prevention of vertebral fractures could be beneficial. Chest LDCT is an opportunity to diagnose vertebral fractures.
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