Efficacy and Tolerability of Treatment of Actinic Keratosis with Tirbanibulin 0.1% Ointment in People Living with HIV Infection

Background: /Objectives: People living with HIV (PLWH) are more susceptible than immunocompetent people to non-melanoma skin cancers. These tumors can arise de novo or from precancerous lesions, such as actinic keratosis (AKs). The AKs management in PLWH has not been widely discussed in the literature. More specifically, the efficacy of AKs treatment in PLWH with modern topical drugs, such as tirbanibulin, is limited. The present work aims to evaluate the efficacy and tolerability of AKs treatment with tirbanibulin 1% ointment in PLWH. Methods: We retrospectively collected the data of the PLWH who visited the Dermatology Department of the Policlinico Riuniti (Foggia, Italy) between September 2023 and September 2024. PLWH who received the diagnosis of AKs and underwent treatment with tirbanibulin 1% ointment were studied. To assess the severity of AKs, the number of AKs and the AKs area and severity index (AKASI) score were calculated at the time of diagnosis (T0) and after treatment (T1). Results: Ten PLWH were found to have AKs and received topical therapy with tirbanibulin 1% ointment. On average, al T0, the number of lesions was 8.2 and the AKASI score was 4.20; at T1, the number of AKs was 1.7 and the AKASI score was 1.5. Only two patients reported a mild inflammatory reaction to applying tirbanibulin 1% ointment. Conclusions: The rate of satisfactory responses was 80%, in line with a recent multicentric Italian study performed on immunocompetent patients. Our results confirm the efficiacy and tolerability of tirbanibulin 1% ointment in treating AKs also in PLWH.