HPV Prevalence Can Increase Over Time in Women with Lupus, Study Finds

The prevalence of human papillomavirus (HPV) infections may increase over time among women with systemic lupus erythematosus (SLE), but more studies are needed to assess the group’s risk, a new study says.

The study, “Incidence Of Cervical Human Papillomavirus Infection In Systemic Lupus Erythematosus Women,” was published in the Lupus journal.

Previous studies have shown that, compared with the general population, the risk of cancer is 15% higher in those with SLE. The number of virus-induced cancer cases appears to be particularly high. HPV infection is considered one of the most common sexually transmitted diseases and the leading cause for the development of cervical cancer, especially among younger women.

To study the relationship between HPV infection and SLE, researchers followed 127 Mexican women with SLE and analyzed several parameters, including social, demographic, and lifestyle factors; gynecologic and clinical measurements to detect HPV infection; use of Rituxan (rituximab) or immunosuppressive agents (azathioprine, leflunomide, methotrexate, mycophenolic acid, and cyclophosphamide) as SLE treatments; and the risk of acquisition and persistence of HPV infection. Patients were evaluated at the study’s start and after three years.

Researchers found that the prevalence of HPV infection increased from baseline, or the study’s start, to three years later (22.8% vs. 33.8%). The frequency of multiple HPV infections increased from 11% at baseline to 15.7% after three years.

At three years, 88.6% of the infections were cleared.

The team identified a higher number of sexual partners (more than two) and cumulative cyclophosphamide dose as HPV risk factors.

“In systemic lupus erythematosus women, the cumulative prevalence of human papillomavirus infection, including high risk-human papillomavirus and multiple human papillomavirus infections, may increase over time,” the team wrote. “Most persistent infections were low risk-human papillomavirus. The number of lifetime sexual partners and the cumulative cyclophosphamide dose were independently associated with incident human papillomavirus infection.”

The researchers acknowledged that the study had some limitations, including the lack of a healthy control group, and said more research is needed to assess the risk of HPV infection and immunosuppressive agents.

“Whether the natural history of HPV infection in SLE patients differs from that of healthy persons would need to be addressed in a future study. Secondly, the majority of our patients did not belong to the highest-risk age group. Therefore, our conclusions should not be applied to younger SLE populations,” the team wrote.