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Persons living with HIV (PLWH) face evolving skin cancer risks, particularly higher rates of squamous cell carcinoma and other rare skin cancers. Antiretroviral therapy influences these risks, necessitating tailored screening and treatment guidelines.

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Area of Science:

  • Dermatology
  • Infectious Diseases
  • Oncology

Background:

  • The incidence of skin cancer in persons living with HIV (PLWH) is influenced by antiretroviral therapy (ART).
  • While keratinocyte carcinomas are common in both PLWH and the general population, PLWH may have an elevated risk for squamous cell carcinoma.
  • Merkel cell carcinoma and sebaceous carcinoma show increased incidence rates among PLWH.

Purpose of the Study:

  • To review the current understanding of skin cancer risks in PLWH.
  • To discuss the impact of HIV, ART, and immune status on skin cancer development and treatment.
  • To highlight the need for specific screening and treatment guidelines for this population.

Main Methods:

  • Literature review of studies investigating skin cancer incidence, risk factors, and treatment outcomes in PLWH.
  • Analysis of the interplay between HIV infection, antiretroviral therapy, immune status, and skin carcinogenesis.
  • Examination of current screening recommendations and therapeutic approaches, including Mohs micrographic surgery and immune checkpoint inhibitors.

Main Results:

  • PLWH may experience a higher risk of squamous cell carcinoma compared to the general population.
  • Increased incidence rates of Merkel cell carcinoma and sebaceous carcinoma are observed in PLWH.
  • Data regarding melanoma risk in PLWH are inconsistent.
  • Immune checkpoint inhibitors appear safe and effective in PLWH, though further research is needed.

Conclusions:

  • The risk of skin cancer in PLWH is multifactorial, influenced by HIV, ART, and immune status.
  • Vigilant surveillance, tailored screening, and specific treatment guidelines are crucial for managing skin cancer in PLWH.
  • Further research is essential to refine understanding and management strategies for skin cancer in this population.