Racial differences in dermatologic conditions associated with HIV

Summary: Abstract Body: Racial differences in dermatoses affecting people living with HIV (PLWH) are understudied, and most research focuses on a Black/White binary. This study used the TriNetX network, a multi-institutional dataset, to compare dermatologic conditions across Asian, Hispanic, Black, and White PLWH. This retrospective cohort study examined dermatologic problems arising after HIV diagnosis in adults. Non-White PLWH were matched to White PLWH by age, sex, socioeconomic status, and comorbidities. Hazard ratios (HR) and 95% confidence intervals were calculated with Cox proportional hazard models. Bonferroni correction was made for multiple testing. A selection of our findings is described here. We identified the following significant racial differences in dermatoses among PLWH. Regarding infectious conditions, Asian, Hispanic, and Black PLWH were at lower risk for verruca vulgaris than White PLWH (HRAsian=0.53, HRHispanic=0.83, HRBlack=0.54). In terms of inflammatory conditions, Asian, Hispanic, and Black PLWH had a higher risk of post-inflammatory hyperpigmentation (HRAsian=4.34, HRHispanic=1.78, HRBlack=4.24) and pruritus (HRAsian=1.82, HRHispanic=1.32, HRBlack=1.37). As it concerns neoplastic conditions, Asian, Hispanic, and Black PLWH had a lower risk of actinic keratosis than their White counterparts (HRAsian=0.11, HRHispanic=0.18, HRBlack=0.04). Hispanic PLWH were found to be at higher risk for Kaposi sarcoma (HR=1.34). This study highlights racial differences in dermatoses affecting PLWH. Disparities in access to care may be a contributing factor. Limitations include limited CD4 count and viral load data and reliance on ICD codes for disease identification. Further studies are needed to explore the underlying mechanisms of race-based differences in HIV-associated dermatoses. Jake Nusynowitz^{1, 2}, Li-Chi Chen³, Nicholas Gessner^{4, 2}, John C. Trinidad² 1. Florida International University, Miami, FL, United States. 2. Massachusetts General Hospital, Boston, MA, United States. 3. University of Massachusetts System, Boston, MA, United States. 4. Brown University Warren Alpert Medical School, Providence, RI, United States. Minoritized Populations and Health Disparities Research