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Risk of skin cancer in patients with HIV: A Danish nationwide cohort study - 19/09/18

Doi : 10.1016/j.jaad.2018.03.024 
Silje Haukali Omland, MD, PhD a, , Magnus Glinvad Ahlström, MD b, Jan Gerstoft, MD, DMSc b, Gitte Pedersen, MD, PhD c, Rajesh Mohey, MD, PhD d, Court Pedersen, MD, DMSc e, Gitte Kronborg, MD, DMSc f, Carsten Schade Larsen, MD, DMSc g, Birgit Kvinesdal, MD, DMSc h, Robert Gniadecki, MD, DMSc a, Niels Obel, MD, DMSc b, Lars Haukali Omland, MD, PhD, DMSc b
a Department of Dermato-Venerology, Faculty of Health Sciences, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark 
b Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark 
c Department of Infectious Diseases, Aalborg University Hospital, Aalborg, Denmark 
d Department of Internal Medicine, The Regional Hospital West Jutland, Herning, Denmark 
e Department of Infectious Diseases, Odense University Hospital, Odense, Denmark 
f Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre Hospital, Copenhagen, Denmark 
g Department of Infectious Diseases, Aarhus University Hospital, Aarhus, Denmark 
h Department of Infectious Diseases, Copenhagen University Hospital, Herlev Hospital, Copenhagen, Denmark 

Correspondence to: Silje Haukali Omland, MD, PhD, Department of Dermato-Venerology, Copenhagen University Hospital, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400 Copenhagen NV, Denmark.Department of Dermato-VenerologyCopenhagen University HospitalBispebjerg HospitalBispebjerg Bakke 23Copenhagen NV2400Denmark

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.

Le texte complet de cet article est disponible en PDF.

Key words : basal cell carcinoma, cohort study, HIV infection, malignant melanoma, skin cancer, squamous cell carcinoma

Abbreviations used : BCC, DCR, DHCS, HAART, IR, IRR, KSC, MM, MSM, PYR, SCC


Plan


 Funding sources: None.
 Dr Gerstoft's institution has received grants and fees for adboards, teaching, and clinical trials from BMS, Gilead, Janssen, Medivir, MSD, and ViiV. Dr Ahlström has received travel grants from GSK and Janssen. Dr Mohey's travel to scientific meetings has been funded by the medical industry. Dr Gniadecki has received honoraria for participation in advisory boards and speaker fees from AbbVie, Amgen, Janssen, Lilly, and Therakos. Dr Pedersen's institution has received grants from Gilead. Dr Larsen has received honoraria for participation in advisory boards and research grants from Gilead and speaker fees from Bristol-Myers Squibb. No other relationships were disclosed.


© 2018  American Academy of Dermatology, Inc.. Publié par Elsevier Masson SAS. Tous droits réservés.
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Vol 79 - N° 4

P. 689-695 - octobre 2018 Retour au numéro
Article précédent Article précédent
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