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 - 2018/10
Y1 - 2018/10
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
SN - 0190-9622
VL - 79
SP - 689
EP - 695
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 4
ER -
