Risk of skin cancer in patients with HIV a Danish nationwide cohort study

67 Background: 68 The risk of skin cancer in HIV-infected patients has not been extensively studied. 69 Objective: 70 To determine the risk of skin cancer in HIV-infected patients and compare it with the risk in the background 71 population. 72 Methods: 73 In a matched, nationwide population-based cohort study we compared the risk of skin cancer in 4280 HIV- 74 infected patients from the Danish HIV cohort study with a background population cohort, according to the 75 level of immunosuppression and route of transmission. 76 Primary outcomes were time to first basal cell carcinoma (BCC), squamous cell carcinoma (SCC), or 77 malignant melanoma (MM). 78 Results: 79 HIV-infected patients had an increased risk of BCC and SCC with IRRs of 1.79 (95% CI 1.43 – 2.22) and 5.40 80 (95% CI 3.07 – 9.52), respectively, compared with the background population. We observed no increased 81 risk of MM. Low nadir CD4 cell count was associated with an increased risk of SCC. The increased risk of BCC 82 among HIV-infected patients was restricted to men who had sex with men. 83 Limitations: 84 Observational design. Small number of patients with melanoma. Conclusion: 86

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