       Document 0005
 DOCN  M9640005
 TI    Lack of usefulness of radiographic screening for pulmonary disease in
       asymptomatic HIV-infected adults. Pulmonary Complications of HIV
       Infection Study Group.
 DT    9604
 AU    Schneider RF; Hansen NI; Rosen MJ; Kvale PA; Fulkerson WJ Jr; Goodman P;
       Meiselman L; Glassroth J; Reichman LB; Wallace JM; Hopewell PC; Beth
       Israel Medical Center, New York, NY, USA.
 SO    Arch Intern Med. 1996 Jan 22;156(2):191-5. Unique Identifier : AIDSLINE
       MED/96136000
 AB    OBJECTIVE: To determine the use of chest radiographs in the screening of
       asymptomatic adults infected with the human immunodeficiency virus
       (HIV). METHODS: A prospective, multicenter study of the pulmonary
       complications of HIV infection in a community-based cohort of persons
       with and without HIV infection. The subjects included 1065
       HIV-seropositive subjects without the acquired immunodeficiency syndrome
       at the time of enrollment: 790 homosexual men, 226 injection drug users,
       and 49 women with heterosexually acquired infection. Frontal and lateral
       chest radiographs were performed at 3-, 6-, and 12-month intervals, CD4
       lymphocyte measurements at 3- and 6-month intervals, tuberculin and
       mumps skin tests at 12-month intervals, and medical histories and
       physical examinations at 3- and 6-month intervals. Pulmonary diagnoses
       that occurred within 2 months following each radiograph were analyzed
       and correlated with the radiographic results. RESULTS: Evaluable
       screening chest radiographs (5263) were performed in HIV-seropositive
       subjects while they were asymptomatic; of these, 5140 (98%) were
       classified as normal and 123 (2%) as abnormal. A new pulmonary diagnosis
       was identified within 2 months following a screening radiograph in 55
       subjects. Only 11 of these subjects had abnormal radiographs; the
       sensitivity of the radiograph was 20%. The sensitivity was similarly low
       at baseline, within each transmission category, and in subjects whose
       CD4 lymphocyte counts were less than 0.2 x 10(9)/L (200/microL). The
       types of pulmonary diseases that occurred were similar in the subjects
       with normal and abnormal screening radiographs. CONCLUSION: Screening
       chest radiography in asymptomatic HIV-infected adults is unwarranted
       because the diagnostic yield is low.
 DE    Adult  AIDS-Related Opportunistic Infections/MICROBIOLOGY/*PREVENTION &
       CONTROL/RADIOGRAPHY  CD4 Lymphocyte Count  Female  Human  HIV
       Infections/*COMPLICATIONS/IMMUNOLOGY/TRANSMISSION  Lung
       Diseases/MICROBIOLOGY/*PREVENTION & CONTROL/RADIOGRAPHY  Male  *Mass
       Chest X-Ray  Population Surveillance  Prospective Studies  Sensitivity
       and Specificity  Support, U.S. Gov't, P.H.S.  CLINICAL TRIAL  JOURNAL
       ARTICLE  MULTICENTER STUDY

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).

