Risk of skin cancer in patients with HIV: A Danish nationwide cohort study

Silje Haukali Omland; Magnus Glinvad Ahlström; Jan Gerstoft; Gitte Pedersen; Rajesh Mohey; Court Pedersen; Gitte Kronborg; Carsten Schade Larsen; Birgit Kvinesdal; Robert Gniadecki; Niels Obel; Lars Haukali Omland

doi:10.1016/j.jaad.2018.03.024

Risk of skin cancer in patients with HIV: A Danish nationwide cohort study

Silje Haukali Omland, Magnus Glinvad Ahlström, Jan Gerstoft, Gitte Pedersen, Rajesh Mohey, Court Pedersen, Gitte Kronborg, Carsten Schade Larsen, Birgit Kvinesdal, Robert Gniadecki, Niels Obel, Lars Haukali Omland

Department of Clinical Medicine

19 Citations (Scopus)

Abstract

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.

Original language	English
Journal	Journal of the American Academy of Dermatology
Volume	79
Issue number	4
Pages (from-to)	689-695
ISSN	0190-9622
DOIs	https://doi.org/10.1016/j.jaad.2018.03.024
Publication status	Published - Oct 2018

Keywords

Adult
Age Distribution
Antiretroviral Therapy, Highly Active/methods
Carcinoma, Basal Cell/diagnosis
Carcinoma, Squamous Cell/diagnosis
Case-Control Studies
Comorbidity
Confidence Intervals
Denmark/epidemiology
Disease-Free Survival
Female
HIV Infections/diagnosis
Humans
Incidence
Male
Middle Aged
Prognosis
Registries
Risk Assessment
Sex Distribution
Skin Neoplasms/diagnosis
Survival Analysis

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1016/j.jaad.2018.03.024

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title = "Risk of skin cancer in patients with HIV: A Danish nationwide cohort study",

abstract = "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.",

keywords = "Adult, Age Distribution, Antiretroviral Therapy, Highly Active/methods, Carcinoma, Basal Cell/diagnosis, Carcinoma, Squamous Cell/diagnosis, Case-Control Studies, Comorbidity, Confidence Intervals, Denmark/epidemiology, Disease-Free Survival, Female, HIV Infections/diagnosis, Humans, Incidence, Male, Middle Aged, Prognosis, Registries, Risk Assessment, Sex Distribution, Skin Neoplasms/diagnosis, Survival Analysis",

author = "Omland, {Silje Haukali} and Ahlstr{\"o}m, {Magnus Glinvad} and Jan Gerstoft and Gitte Pedersen and Rajesh Mohey and Court Pedersen and Gitte Kronborg and Larsen, {Carsten Schade} and Birgit Kvinesdal and Robert Gniadecki and Niels Obel and Omland, {Lars Haukali}",

year = "2018",

month = oct,

doi = "10.1016/j.jaad.2018.03.024",

language = "English",

volume = "79",

pages = "689--695",

journal = "Journal of the American Academy of Dermatology",

issn = "0190-9622",

publisher = "Mosby Inc.",

number = "4",

}

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

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 -

Risk of skin cancer in patients with HIV: A Danish nationwide cohort study

Abstract

Keywords

UN SDGs

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