Risk Factors of Asgari et al for Squamous Cell Carcinoma of the Skin in an HIV-Positive Patient with a History of Nonmelanoma Skin Cancer (NMSC)

Description

Asgari et al identified risk factors for squamous cell carcinoma of the skin in an HIV-positive patient with a history of nonmelanoma skin cancer (NMSC). These can help to identify a patient who may benefit from closer monitoring for skin cancers. The authors are from Massachusetts General Hospital, Harvard Medical School, and Kaiser Permanente Northern California.

Patient selection: HIV-positive patient with a history of nonmelanoma skin cancer (most of the patients were male; mean age in mid-50's)

Nonmelanoma skin cancer = basal cell or squamous cell carcinoma. An HIV-positive patient has a 2.8-fold risk of a NMSC compared to a patient who is HIV-negative.

Outcome: de novo squamous cell carcinoma

Parameters:

(1) CD4 lymphocyte count per microliter

(2) viral load in copies per mL

Parameter	Finding	Adjusted Hazard Ratio
CD4 lymphocyte count	< 200	2.2
	200 to 499	1.1
	>= 500	0.9
viral load	< 500	1
	500 to 9,999	1.5
	>= 10,000	2.3

cumulative hazard ratio =

= PRODUCT(aHR CD4 count, aHR viral load)

A patient who is HIV-positive should be screened for skin cancer, especially if risk factors for immune dysfunction are present.

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Risk Factors of Asgari et al for Squamous Cell Carcinoma of the Skin in an HIV-Positive Patient with a History of Nonmelanoma Skin Cancer (NMSC)

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