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.

中文翻译：

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HIV 患者患皮肤癌的风险：一项丹麦全国队列研究

背景

HIV 患者患皮肤癌的风险尚未得到广泛研究。

客观的

我们试图确定 HIV 患者患皮肤癌的风险，并将其与背景人群的风险进行比较。

方法

在一项匹配的、全国性的、基于人群的队列研究中，我们根据免疫抑制水平和传播途径，比较了来自丹麦 HIV 队列研究的 4280 名 HIV 感染者与背景人群队列的皮肤癌风险。主要结果是首次发生基底细胞癌 (BCC)、鳞状细胞癌 (SCC) 或恶性黑色素瘤的时间。

结果

与背景人群相比，HIV 患者患 BCC 和 SCC 的风险增加，发生率分别为 1.79（95% 置信区间 1.43-2.22）和 5.40（95% 置信区间 3.07-9.52）。我们没有观察到恶性黑色素瘤的风险增加。低最低点 CD4 细胞计数与鳞状细胞癌风险增加有关。HIV 患者患 BCC 的风险增加仅限于男男性行为者。

限制

这项研究是观察性的，包括少数黑色素瘤患者。

结论

HIV 患者患 BCC 和 SCC 的风险增加。低最低点，但不是当前，CD4 细胞计数作为免疫抑制的标志与 SCC 风险增加有关。