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

*Corresponding author for this work

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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 languageEnglish
JournalJournal of the American Academy of Dermatology
Volume79
Issue number4
Pages (from-to)689-695
ISSN0190-9622
DOIs
Publication statusPublished - 26. Mar 2018

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Skin Neoplasms
Cohort Studies
HIV
Melanoma
Population
Confidence Intervals

Keywords

  • basal cell carcinoma
  • cohort study
  • HIV infection
  • malignant melanoma
  • skin cancer
  • squamous cell carcinoma

Cite this

Omland, S. H., Ahlström, M. G., Gerstoft, J., Pedersen, G., Mohey, R., Pedersen, C., ... Omland, L. H. (2018). Risk of skin cancer in patients with HIV: A Danish nationwide cohort study. Journal of the American Academy of Dermatology, 79(4), 689-695. https://doi.org/10.1016/j.jaad.2018.03.024
Omland, Silje Haukali ; Ahlström, Magnus Glinvad ; Gerstoft, Jan ; Pedersen, Gitte ; Mohey, Rajesh ; Pedersen, Court ; Kronborg, Gitte ; Larsen, Carsten Schade ; Kvinesdal, Birgit ; Gniadecki, Robert ; Obel, Niels ; Omland, Lars Haukali. / Risk of skin cancer in patients with HIV : A Danish nationwide cohort study. In: Journal of the American Academy of Dermatology. 2018 ; Vol. 79, No. 4. pp. 689-695.
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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.",
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Omland, SH, Ahlström, MG, Gerstoft, J, Pedersen, G, Mohey, R, Pedersen, C, Kronborg, G, Larsen, CS, Kvinesdal, B, Gniadecki, R, Obel, N & Omland, LH 2018, 'Risk of skin cancer in patients with HIV: A Danish nationwide cohort study', Journal of the American Academy of Dermatology, vol. 79, no. 4, pp. 689-695. https://doi.org/10.1016/j.jaad.2018.03.024

Risk of skin cancer in patients with HIV : A Danish nationwide cohort study. / Omland, Silje Haukali; Ahlström, Magnus Glinvad; Gerstoft, Jan; Pedersen, Gitte; Mohey, Rajesh; Pedersen, Court; Kronborg, Gitte; Larsen, Carsten Schade; Kvinesdal, Birgit; Gniadecki, Robert; Obel, Niels; Omland, Lars Haukali.

In: Journal of the American Academy of Dermatology, Vol. 79, No. 4, 26.03.2018, p. 689-695.

Research output: Contribution to journalJournal articleResearchpeer-review

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 - 2018/3/26

Y1 - 2018/3/26

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 - basal cell carcinoma

KW - cohort study

KW - HIV infection

KW - malignant melanoma

KW - skin cancer

KW - squamous cell carcinoma

U2 - 10.1016/j.jaad.2018.03.024

DO - 10.1016/j.jaad.2018.03.024

M3 - Journal article

C2 - 29588249

AN - SCOPUS:85051707726

VL - 79

SP - 689

EP - 695

JO - American Academy of Dermatology. Journal

JF - American Academy of Dermatology. Journal

SN - 0190-9622

IS - 4

ER -