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HIV infection associated with subsequent squamous cell carcinoma risk

Non-Hispanic white patients with HIV and a history of nonmelanoma skin cancer had a higher risk for subsequent new primary squamous cell carcinoma, which was particularly associated with lower CD4 counts and higher viral loads, when compared with patients without HIV, according to recently published study results.

Researchers conducted a cohort study of 455 patients with HIV (mean age, 52.6 years; 3% women) and 1,945 patients without HIV (mean age, 55.5 years; 8% women) who were diagnosed with at least one nonmelanoma skin cancer (NMSC) between 1996 and 2008 to determine risk for subsequent NMSCs in relation to CD4 count and viral load. NMSC was defined as basal cell carcinoma (BCC) or squamous cell carcinoma (SCC)

All patients were members of the Kaiser Permanente Northern California health care plan, white, non-Hispanic, aged 18 years or older and had at least one NMSC during the study period.

The median duration of observation was 4.6 years.

Patients with HIV were slightly younger, more likely to be men (97% vs. 92%) and to have smoked (57% vs. 45%), and less likely to be overweight or obese (50% vs. 61%) compared with patients without HIV.

There was a 44% increased risk for subsequent NMSC and 222% increased risk for subsequent SCC in patients with HIV and a CD4 count less than 200 cells/mL, a biomarker of more severe immune deficiency, when compared with patients who were without HIV.

“Our findings suggest that HIV infection and its associated immunodeficiency contribute to the higher risk of NMSC overall and SCC,” the researchers wrote. “Clinical implications of our findings suggest a potential benefit from targeted monitoring for SCC among HIV-infected individuals, particularly those with low CD4 counts or high [viral loads].” – by Bruce Thiel

Disclosure: Asgari reports having served as an investigator for studies funded by Valeant Pharmaceuticals and Pfizer. Please see the full study for a listing of the other researchers’ relevant financial disclosures.