Background/Purpose: Viral infection has been considered as an exogeneous risk factor for primary Sjogren’s syndrome (pSS). We determined whether human papillomavirus (HPV) infection was associated with the risk of pSS in this population-based propensity score-matched cohort study.

Methods: In this cohort study, 47,300 patients with HPV infection and 189,200 propensity score-matched controls without HPV infection were enrolled. A Cox proportional hazard model was utilized to estimate the risk of pSS and survival analysis was adopted to assess the time-dependent effect of HPV infection on pSS. Subgroup analyses stratified by age, gender, and follow-up years were conducted to identify susceptible populations.

Results: Of all patients with HPV, 493 developed pSS (incidence rate=13.61 per 100,000 person-months, 95%CI=12.46-14.86). Patients with HPV infection were more likely to develop pSS than controls without HPV infection (incidence rate ratio=1.81, 95%CI=1.63-2.01; hazard ratio, HR =1.64, 95% CI =1.47–1.83, P < 0.0001), which persisted in the survival analysis (log-rank test P < 0.0001). The effect of HPV on pSS was significant in HPV-infected patients from both genders and all age subgroups, including male patients (HR=1.83, 95% CI = 1.47–2.28, P < 0.0001), female patients (HR=1.58, 95% CI = 1.40–1.79, P < 0.0001), patients aged between 16 and 45 (HR=1.60, 95% CI = 1.34–1.91, P < 0.0001), and patients older than 45 (HR=1.67, 95% CI = 1.46–1.91, P < 0.0001), all compared with respective matched controls without HPV infection.

Conclusion: This is the first longitudinal study that addresses the relationship between HPV infection and risk of pSS. Based on the observed relationship, regular follow-up in the rheumatology clinic is recommended for patients with HPV infection.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/human-papillomavirus-infection-increases-risk-of-primary-sjogrens-syndrome-a-population-based-cohort-study-over-a-15-year-follow-up/