High risk of human papillomavirus type 16 infections and of development of cervical squamous intraepithelial lesions in systemic lupus erythematosus patients

Arthritis Rheum. 2007 May 15;57(4):619-25. doi: 10.1002/art.22667.

Abstract

Objective: To determine rates of human papillomavirus (HPV) infections, abnormal cervical smears, and squamous intraepithelial lesions (SIL) among women with systemic lupus erythematosus (SLE).

Methods: We investigated 30 women with SLE, 67 with abnormal smears from colposcopy clinics, and 15 community subjects with normal smears. Polymerase chain reaction results for viral DNA and HPV-16 sequencing data were correlated to cytology and colposcopic findings.

Results: SLE and colposcopy patients were more likely (P < 0.05) to be HPV positive (15 [54%] and 37 [67%] patients, respectively) and HPV-16 DNA positive (16 [57%] and 17 [31%] patients, respectively) than community subjects (0% HPV DNA positive and 1 [6%] HPV-16 DNA positive). SLE patients were also more likely to be HPV-16 DNA positive than colposcopy patients (P < 0.05). SLE patients with a high HPV-16 viral load more frequently had SIL (n = 6) than those with a low HPV-16 viral load (n = 1; P < 0.05). HPV and HPV-16 DNA positivity were not associated with previous or current drug therapy for SLE patients. All HPV-16 DNA sequences from 6 SLE and 5 colposcopy patients were the European-type variant. Eighteen (60%) SLE patients had a previous or current cervical abnormality. At the time of study, 5 (17%) SLE patients had an abnormal cervical smear and 8 (27%) had SIL. For those diagnosed with SLE for >10 years, the rate of SIL was 44% lower than those with SLE for <5 years (odds ratio 0.56, 95% confidence interval 0.1-3.5).

Conclusion: UK women with a recent SLE diagnosis had disturbingly elevated levels of HPV infections (particularly with European HPV-16 variants at a high viral load), abnormal cervical cytology, and SIL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Carcinoma, Squamous Cell / epidemiology
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / virology
  • Cervical Intraepithelial Neoplasia / epidemiology*
  • Cervical Intraepithelial Neoplasia / pathology
  • Cervical Intraepithelial Neoplasia / virology
  • Colposcopy
  • DNA, Viral / analysis
  • Female
  • Human papillomavirus 16 / genetics
  • Human papillomavirus 16 / isolation & purification*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / epidemiology*
  • Middle Aged
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / pathology
  • Polymerase Chain Reaction
  • Risk Factors
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / virology
  • Viral Load

Substances

  • DNA, Viral
  • Immunosuppressive Agents