Research Summary

Dermatologic Disease Rates Decline Among People With HIV

Kate Young

Key Highlights:

  • Nearly half of adults with HIV in the DC cohort had at least one dermatologic diagnosis.
  • Incidence of infectious, inflammatory, and malignant skin conditions declined significantly from 2011 to 2024.
  • Cisgender women and individuals with lower nadir CD4 counts faced higher dermatologic disease risk.

The incidence of dermatologic disease (DD) has decreased among people with human immunodeficiency virus (HIV) in the modern antiretroviral therapy (ART) era, according to a study published in the Journal of the American Academy of Dermatology. Researchers analyzed more than a decade of patient data from the DC Cohort, a longitudinal research project that currently includes more than 13,000 people with HIV (PWH), to better understand the epidemiology of skin conditions among this patient population. While rates of infectious, inflammatory, and malignant dermatoses have fallen, nearly half of participants experienced at least one dermatologic condition, highlighting ongoing clinical challenges.

Investigators conducted a longitudinal cohort analysis of 11,738 adults enrolled in the DC Cohort between 2011 and 2023. Dermatologic diagnoses were identified through ICD-9 and ICD-10 codes and classified into three categories: infectious dermatoses, inflammatory dermatoses, and cutaneous malignancies. The team assessed prevalence and incidence trends over time and used multivariable logistic regression models to identify independent risk factors for dermatologic disease.

Study Findings

Of the total cohort, 49.4% of participants had at least one dermatologic diagnosis, with infectious skin conditions representing the most common category (41.4%). Over the 12-year study period, incidence rates declined markedly across all dermatologic categories. Infectious conditions decreased from 463 to 41 cases per 1000 individuals, inflammatory conditions from 306 to 62, and cutaneous malignancies from 31 to 6 (all P < .0001).

Cisgender women exhibited more than sixfold higher odds of developing cutaneous malignancy compared with other groups. Additional risk factors included older age, lower nadir CD4 count, prior opportunistic infections, and public insurance status. These associations emphasize the combined influence of immune, demographic, and structural determinants on dermatologic outcomes in HIV care.

Clinical Implications

Despite significant progress in ART and overall HIV management, dermatologic disease remains a common comorbidity among people with HIV. The study’s findings suggest that immune restoration and access to comprehensive care have contributed to the decline in DD incidence. However, the persistence of high prevalence rates—especially among women and immunocompromised individuals—indicates a need for continued dermatologic surveillance and equitable care access within HIV treatment frameworks.

Expert Commentary

“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,” the researchers concluded.

Reference:
Nguyen ML, et al. Prevalence, incidence, and risk factors of dermatologic disease among people with HIV: Findings from the DC Cohort, 2011–2023. J Am Acad Dermatol. 2025;S0190-9622(25)02804-X. doi:10.1016/j.jaad.2025.10.004.