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      <title>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</title>
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    <abstract>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 &lt;350 per microliter and an actual CD4 T-cell count &gt;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 &lt;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.</abstract>
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    <subject>
      <topic>HIV</topic>
      <topic>vertebral fracture</topic>
      <topic>osteoporosis</topic>
      <topic>computed tomography</topic>
      <topic>smoking</topic>
      <topic>lung cancer</topic>
    </subject>
    <classification authority="local">050</classification>
    <classification authority="local">052</classification>
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      <titleInfo>
        <title>Jaids.Journal of Acquired Immune Deficiency Syndromes</title>
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      <part>
        <detail type="volume">
          <number>69</number>
        </detail>
        <detail type="volume">
          <number>3</number>
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        <extent unit="pages">
          <list> 299-305</list>
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      <originInfo>
        <dateIssued>2015</dateIssued>
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      <identifier type="issn">1525-4135</identifier>
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    <identifier type="uri">https://www.documentation.ird.fr/hor/fdi:010064765</identifier>
    <identifier type="doi">10.1097/qai.0000000000000599</identifier>
    <identifier type="issn">1525-4135</identifier>
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      <recordCreationDate encoding="w3cdtf">2015-07-29</recordCreationDate>
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