Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2026 Jan;94(1):128-142.
doi: 10.1016/j.jaad.2025.09.020. Epub 2025 Oct 14.

Prevalence, incidence, and risk factors for dermatologic conditions in people with HIV in the modern antiretroviral era: A cohort study in Washington, DC

Yagiz Matthew Akiska  1 , Morgan Byrne  2 , Mana Nasseri  3 , Adeline Koay  4 , Michael A Horberg  5 , Anne Monroe  2 , Adam Friedman  6 , Natella Rakhmanina  7 ; DC Cohort Executive Committee
Affiliations

Prevalence, incidence, and risk factors for dermatologic conditions in people with HIV in the modern antiretroviral era: A cohort study in Washington, DC

Yagiz Matthew Akiska et al. J Am Acad Dermatol. 2026 Jan.

Abstract

Background: Dermatologic disease (DD) remains a significant morbidity among people with human immunodeficiency virus (HIV) (PWH), yet epidemiologic data in the modern antiretroviral therapy (ART) era are limited.

Objective: To characterize the prevalence, incidence, and risk factors of DD among PWH.

Methods: This longitudinal cohort study included 11,738 adults enrolled in the DC Cohort between 2011 and 2023. DDs were identified using ICD-9/10 codes and categorized as infectious dermatoses, inflammatory dermatoses, or cutaneous malignancies (CM). Prevalence, incidence trends, and multivariable logistic regression were used to identify risk factors.

Results: Among participants, 49.4% had ≥1 dermatologic diagnosis, with infectious conditions most common (41.4%). Incidence declined from 2011 to 2024 across all categories: infectious (463 to 41), inflammatory (306 to 62), and malignant (31 to 6) cases per 1000 (all P < .0001). Cisgender females had over sixfold greater odds of CM. Lower nadir CD4 count, older age, public insurance, and prior opportunistic infections were associated with higher DD risk.

Limitations: Use of ICD codes may have introduced misclassification; dermatology specialty access likely varied by site.

Conclusion: DD incidence has declined over time, reflecting advances in HIV care and treatment. Despite modern ART, DD remains prevalent. Demographic, immune, structural, and behavioral factors drive risk among PWH, underscoring the need for targeted care.

Keywords: HIV; antiretroviral therapy; cohort study; cutaneous malignancy; dermatology; infectious disease; inflammatory dermatoses; marginalized population; skin cancer; skin disease.

PubMed Disclaimer

Conflict of interest statement

Conflicts of interest The authors declare no conflicts of interest. The views expressed in this article are those of the authors and do not necessarily reflect the position or the policy of the Department of Veterans Affairs, the National Institutes of Health (NIH), or the United States government.

References

    1. World Health Organization (WHO). HIV and AIDS. https://www.who.int/news-room/fact-sheets/detail/hiv-aids.
    1. Mowla MR, Manchur MA, Islam AQMS, Maurer T Cutaneous Manifestations of HIV/AIDS in the Era of Highly Active Antiretroviral Therapy: Evidence from Bangladesh. Int J Dermatol Venereol 2022;5(1):8–14. doi: 10.1097/JD9.0000000000000205 - DOI
    1. Chelidze K, Thomas C, Chang AY, Freeman EE. HIV-Related Skin Disease in the Era of Antiretroviral Therapy: Recognition and Management. Am J Clin Dermatol 2019;20(3):423–442. doi: 10.1007/s40257-019-00422-0 - DOI - PMC - PubMed
    1. World Health Organization. Guidelines on the Treatment of Skin and Oral HIV-Associated Conditions in Children and Adults; 2014. Accessed March 28, 2025. https://www.ncbi.nlm.nih.gov/books/NBK305417/
    1. Franceschi S, Maso LD, Rickenbach M, et al. Kaposi sarcoma incidence in the Swiss HIV Cohort Study before and after highly active antiretroviral therapy. Br J Cancer. 2008;99(5):800–804. doi: 10.1038/sj.bjc.6604520 - DOI - PMC - PubMed

Substances