368. Incidental Findings on Brain MRI in People Living with HIV

Abstract

BackgroundHIV infection is associated with an array of neurocognitive changes, collectively referred to as HIV-Associated Neurocognitive Disorder (HAND). These changes have been the subject of a great deal of study, often including structural MRI of the brain. Incidental findings (IF) are a well-known complication of imaging studies done for both diagnostic and research indications, and can pose important ethical and clinical dilemmas. Little is known about the rates and types of IF found on brain MRI in patients with HIV infection. We identified and characterized such findings in participants who participated in a study of neurophysiological markers of HAND.MethodsThe parent study included 108 HIV-infected adults and 125 demographically matched uninfected controls without cognitive impairment who had undergone T1-weighted structural brain MRI for research purposes. Demographic and diagnostic data were abstracted from the research records. Each MRI study was read by the same neuroradiologist, blind to the participant’s HIV status. IF were classified as vascular, neoplastic, congenital, other neurologic, or non-neurologic. Categorical measures were compared using Pearson chi-square tests while continuous measures were compared using t-tests.ResultsAmong HIV-infected participants, 36/108 (33.3%) had IF compared with 33/125 (26.4%) of controls (P = 0.248). Rates of IF were significantly correlated with increased age in both HIV-infected and control participants. We found no correlation among presence or absence of IF and sex, race/ethnicity, or CD4 count and HAND status for the HIV-infected cohort. The most common categories were neurologic (27), followed by non-neurologic (8), vascular (6), and neoplastic (2) (Table 1).ConclusionIf were common in both HIV-infected participants and controls, at higher rates than previously reported, possibly because of increased sensitivity of MRI machines over time. Surprisingly, we found no significant difference between the groups and no correlation with HAND status or CD4 count. Age was the only factor correlated with rates of IF in either HIV-infected participants or controls. To our knowledge, this study is the first of its kind to characterize incidental findings in HIV-infected patients. Disclosures All authors: No reported disclosures.