Department of Dermato-Venerology, Faculty of Health Sciences, Copenhagen University Hospital, Bispebjerg Hospital, Copenhagen, Denmark.
Department of Infectious Diseases, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
J Am Acad Dermatol. 2018 Oct;79(4):689-695. doi: 10.1016/j.jaad.2018.03.024. Epub 2018 Mar 26.
The risk of skin cancer in patients with HIV has not been extensively studied.
We sought to determine the risk of skin cancer in patients with HIV and compare it with the risk in the background population.
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.
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.
This study was observational and included a small number of patients with melanoma.
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.
HIV 感染者的皮肤癌风险尚未得到广泛研究。
我们旨在确定 HIV 感染者皮肤癌的风险，并与背景人群进行比较。
在一项匹配的、全国性的、基于人群的队列研究中，我们根据免疫抑制程度和传播途径，将来自丹麦 HIV 队列研究的 4280 名 HIV 感染者与背景人群队列进行了比较，以确定皮肤癌的风险。主要结局是首次基底细胞癌（BCC）、鳞状细胞癌（SCC）或恶性黑色素瘤的发病时间。
与背景人群相比，HIV 感染者的 BCC 和 SCC 发病风险增加，发病率比分别为 1.79（95%置信区间 1.43-2.22）和 5.40（95%置信区间 3.07-9.52）。我们未观察到恶性黑色素瘤发病风险增加。低 CD4 细胞最低点计数与 SCC 发病风险增加相关。HIV 感染者的 BCC 发病风险增加仅限于男男性行为者。
本研究为观察性研究，且黑色素瘤患者数量较少。
HIV 感染者患 BCC 和 SCC 的风险增加。低 CD4 细胞最低点计数（而非当前计数）作为免疫抑制的标志物，与 SCC 发病风险增加相关。
