Silje Haukali Omland1, Magnus Glinvad Ahlström2, Jan Gerstoft2, Gitte Pedersen3, Rajesh Mohey4, Court Pedersen5, Gitte Kronborg6, Carsten Schade Larsen7, Birgit Kvinesdal8, Robert Gniadecki9, Niels Obel2, Lars Haukali Omland2. 1. Department of Dermato-Venerology, Faculty of Health Sciences, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark. Electronic address: Silje.haukali.omland.01@regionh.dk. 2. Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. 3. Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark. 4. Department of Internal Medicine, The Regional Hospital West Jutland, Herning, Denmark. 5. Department of Infectious Diseases, Odense University Hospital, Odense, Denmark. 6. Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre Hospital, Copenhagen, Denmark. 7. Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark. 8. Department of Infectious Diseases, Copenhagen University Hospital, Herlev Hospital, Copenhagen, Denmark. 9. Department of Dermato-Venerology, Faculty of Health Sciences, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark.
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.
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.
Authors: Amanda Blair Spence; Matthew E Levy; Anne Monroe; Amanda Castel; Joseph Timpone; Michael Horberg; Lucile Adams-Campbell; Princy Kumar Journal: J Community Health Date: 2021-02
Authors: Caradee Y Wright; D Jean du Preez; Danielle A Millar; Mary Norval Journal: Int J Environ Res Public Health Date: 2020-02-06 Impact factor: 3.390