Brief Report: Cutaneous Melanoma Risk Among People With HIV in the United States and Canada

Yanik, Elizabeth L.; Hernández-Ramírez, Raúl Ulises; Qin, Li; Lin, Haiqun; Leyden, Wendy A.; Neugebauer, Romain; Horberg, Michael A.; Moore, Richard D.; Mathews, W. Christopher; Justice, Amy C.; Hessol, Nancy A.; Mayor, Angel M.; Gill, M John; Brooks, John T.; Sun, Jing; Althoff, Keri N.; Engels, Eric A.; Silverberg, Michael J.; Dubrow, Robert

doi:10.1097/qai.0000000000001719

Cited by 19 publications

(9 citation statements)

References 23 publications

(30 reference statements)

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“…However, it could also be a spurious finding if some KS cases were misclassified as other soft tissue sarcomas. For malignant melanoma of the skin, we found a weak association with lower CD4 counts, but previous studies showed conflicting results [11,36]. The observation that some cancers currently categorized as infection-unrelated showed an association with lower CD4 counts could indicate that an unknown infectious cause may contribute to the development of these cancers.…”

Section: Discussioncontrasting

confidence: 51%

Immunodeficiency and Cancer in 3.5 Million People Living With Human Immunodeficiency Virus (HIV): The South African HIV Cancer Match Study

Ruffieux

Muchengeti

Egger

et al. 2021

Clinical Infectious Diseases

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Background We analysed associations between immunodeficiency and cancer incidence in a nationwide cohort of people living with the human immunodeficiency virus (HIV) in South Africa. Methods We used data from the South African HIV Cancer Match study built on HIV-related laboratory measurements from the National Health Laboratory Services and cancer records from the National Cancer Registry. We evaluated associations between time-updated CD4 cell count and cancer incidence rates using Cox proportional hazards models. We reported adjusted hazard ratios (aHR) over a grid of CD4 values and estimated the aHR per 100 CD4 cells/µl decrease. Results Of 3,532,266 people living with HIV (PLWH), 15,078 developed cancer. The most common cancers were cervical cancer (4,150 cases), Kaposi sarcoma (2,262 cases), and non-Hodgkin lymphoma (1,060 cases). The association between lower CD4 cell count and higher cancer incidence rates was strongest for conjunctival cancer (aHR per 100 CD4 cells/µl decrease: 1.46, 95% confidence interval [CI] 1.38-1.54), Kaposi sarcoma (aHR 1.23, 95% CI 1.20-1.26), and non-Hodgkin lymphoma (aHR 1.18, 95% CI 1.14-1.22). Among infection-unrelated cancers, lower CD4 cell counts were associated with higher incidence rates of oesophageal cancer (aHR 1.06, 95 CI 1.00-1.11), but not breast, lung, or prostate cancer. Conclusions Lower CD4 cell counts were associated with an increased risk of developing various infection-related cancers among PLWH. Reducing HIV-induced immunodeficiency may be a potent cancer prevention strategy among PLWH in sub-Saharan Africa, a region heavily burdened by cancers attributable to infections.

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Section: Discussioncontrasting

confidence: 51%

Immunodeficiency and Cancer in 3.5 Million People Living With Human Immunodeficiency Virus (HIV): The South African HIV Cancer Match Study

Ruffieux

Muchengeti

Egger

et al. 2021

Clinical Infectious Diseases

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“…Recent reports investigating the risk of CM in White HIV-positive patients in North America [40] and Denmark [39] found no difference compared with the general population. As is the case for CM in immunocompetent individuals, older age and higher sun exposure were associated with an increased risk [40]. It is of interest that CM incidence increased slightly in those patients treated with antiretroviral therapy for the previous two years [40].…”

Section: Risk Factors For the Development Of Skin Cancer In Southern mentioning

confidence: 91%

“…An equivalent study in Denmark revealed a five-fold increase in SCC rate and a 1.8-fold increase in BCC in HIV-positive patients [39]. Recent reports investigating the risk of CM in White HIV-positive patients in North America [40] and Denmark [39] found no difference compared with the general population. As is the case for CM in immunocompetent individuals, older age and higher sun exposure were associated with an increased risk [40].…”

Section: Risk Factors For the Development Of Skin Cancer In Southern mentioning

confidence: 96%

“…As is the case for CM in immunocompetent individuals, older age and higher sun exposure were associated with an increased risk [40]. It is of interest that CM incidence increased slightly in those patients treated with antiretroviral therapy for the previous two years [40]. This was suggested to be due to regular skin surveillance and not to the medication.…”

Section: Risk Factors For the Development Of Skin Cancer In Southern mentioning

confidence: 98%

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The Epidemiology of Skin Cancer and Public Health Strategies for Its Prevention in Southern Africa

Wright

Preez

Millar

et al. 2020

IJERPH

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Skin cancer is a non-communicable disease that has been underexplored in Africa, including Southern Africa. Exposure to solar ultraviolet radiation (UVR) is an important, potentially modifiable risk factor for skin cancer. The countries which comprise Southern Africa are Botswana, Lesotho, Namibia, South Africa, and Swaziland. They differ in population size and composition and experience different levels of solar UVR. Here, the epidemiology and prevalence of skin cancer in Southern African countries are outlined. Information is provided on skin cancer prevention campaigns in these countries, and evidence sought to support recommendations for skin cancer prevention, especially for people with fair skin, or oculocutaneous albinism or HIV-AIDS who are at the greatest risk. Consideration is given to the possible impacts of climate change on skin cancer in Southern Africa and the need for adaptation and human behavioural change is emphasized.

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“…The data are mixed regarding whether HIV infection is linked to a higher incidence of melanoma. In one recent epidemiologic study of patients living in the US or Canada, melanoma incidence was not found to be higher in PLWH 49 . Conversely, in another recent study, PLWH were significantly more likely than non-HIV-infected persons to be diagnosed with advanced-stage melanoma 50 .…”

Section: Hiv and Skin Cancermentioning

confidence: 89%

What’s new in HIV dermatology?

Coates

Leslie

2019

F1000Res

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HIV has long been associated with a number of inflammatory, infectious, and neoplastic skin conditions. In the era of anti-retroviral therapy, we have discovered even more about the relationship between skin disease and chronic immunosuppression. In particular, clinicians still face the propensity of persons living with HIV to develop difficult-to-control viral infections, chronic skin inflammation, and pruritus and—particularly as patients age—various types of skin cancers. Here, we summarize recent updates in the field of HIV dermatology and make recommendations to providers caring for these patients.

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Brief Report: Cutaneous Melanoma Risk Among People With HIV in the United States and Canada

Cited by 19 publications

References 23 publications

Immunodeficiency and Cancer in 3.5 Million People Living With Human Immunodeficiency Virus (HIV): The South African HIV Cancer Match Study

Immunodeficiency and Cancer in 3.5 Million People Living With Human Immunodeficiency Virus (HIV): The South African HIV Cancer Match Study

The Epidemiology of Skin Cancer and Public Health Strategies for Its Prevention in Southern Africa

What’s new in HIV dermatology?

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