TY - JOUR

T1 - Risk of skin cancer in patients with HIV

T2 - A Danish nationwide cohort study

AU - Omland, Silje Haukali

AU - Ahlström, Magnus Glinvad

AU - Gerstoft, Jan

AU - Pedersen, Gitte

AU - Mohey, Rajesh

AU - Pedersen, Court

AU - Kronborg, Gitte

AU - Larsen, Carsten Schade

AU - Kvinesdal, Birgit

AU - Gniadecki, Robert

AU - Obel, Niels

AU - Omland, Lars Haukali

N1 - Copyright © 2018 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

PY - 2018

Y1 - 2018

N2 - BACKGROUND: The risk of skin cancer in patients with HIV has not been extensively studied.OBJECTIVE: We sought to determine the risk of skin cancer in patients with HIV and compare it with the risk in the background population.METHODS: In a matched, nationwide, population-based cohort study, we compared the risk of skin cancer in 4280 patients with HIV from the Danish HIV cohort study with a background population cohort, according to the level of immunosuppression and route of transmission. Primary outcomes were time to first basal cell carcinoma (BCC), squamous cell carcinoma (SCC), or malignant melanoma.RESULTS: Patients with HIV had an increased risk of BCC and SCC with incident rate ratios of 1.79 (95% confidence interval 1.43-2.22) and 5.40 (95% confidence interval 3.07-9.52), respectively, compared with the background population. We observed no increased risk of malignant melanoma. Low nadir CD4 cell count was associated with an increased risk of SCC. The increased risk of BCC among patients with HIV was restricted to men who had sex with men.LIMITATIONS: This study was observational and included a small number of patients with melanoma.CONCLUSION: Patients with HIV have an increased risk of BCC and SCC. Low nadir, but not current, CD4 cell count as a marker of immunosuppression was associated with an increased risk of SCC.

AB - BACKGROUND: The risk of skin cancer in patients with HIV has not been extensively studied.OBJECTIVE: We sought to determine the risk of skin cancer in patients with HIV and compare it with the risk in the background population.METHODS: In a matched, nationwide, population-based cohort study, we compared the risk of skin cancer in 4280 patients with HIV from the Danish HIV cohort study with a background population cohort, according to the level of immunosuppression and route of transmission. Primary outcomes were time to first basal cell carcinoma (BCC), squamous cell carcinoma (SCC), or malignant melanoma.RESULTS: Patients with HIV had an increased risk of BCC and SCC with incident rate ratios of 1.79 (95% confidence interval 1.43-2.22) and 5.40 (95% confidence interval 3.07-9.52), respectively, compared with the background population. We observed no increased risk of malignant melanoma. Low nadir CD4 cell count was associated with an increased risk of SCC. The increased risk of BCC among patients with HIV was restricted to men who had sex with men.LIMITATIONS: This study was observational and included a small number of patients with melanoma.CONCLUSION: Patients with HIV have an increased risk of BCC and SCC. Low nadir, but not current, CD4 cell count as a marker of immunosuppression was associated with an increased risk of SCC.

KW - Adult

KW - Age Distribution

KW - Antiretroviral Therapy, Highly Active/methods

KW - Carcinoma, Basal Cell/diagnosis

KW - Carcinoma, Squamous Cell/diagnosis

KW - Case-Control Studies

KW - Comorbidity

KW - Confidence Intervals

KW - Denmark/epidemiology

KW - Disease-Free Survival

KW - Female

KW - HIV Infections/diagnosis

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Registries

KW - Risk Assessment

KW - Sex Distribution

KW - Skin Neoplasms/diagnosis

KW - Survival Analysis

U2 - 10.1016/j.jaad.2018.03.024

DO - 10.1016/j.jaad.2018.03.024

M3 - Journal article

C2 - 29588249

VL - 79

SP - 689

EP - 695

JO - American Academy of Dermatology. Journal

JF - American Academy of Dermatology. Journal

SN - 0190-9622

IS - 4

ER -