Incidence and Persistence of Cervical Human Papillomavirus Infection in Mexican Systemic Lupus Erythematosus Women

Claudia Mendoza Pinto¹, Mario García-Carrasco^2,3, Verónica Vallejo-Ruiz⁴, Socorro Méndez-Martínez⁵, Alejandro Taboada-Cole⁶, José Luis Totolhua Ramírez⁷, Julio Reyes-Leyva⁴ and Aurelio López-Colombo⁸, ¹Systemic Autoimmune Diseases Research Unit, HGR 36-CIBIOR, Instituto Mexicano del Seguro Social, Puebla, Mexico, ²Systemic Autoimmune Diseases Research Unit, HGR 36-CIBIOR Instituto Mexicano del Seguro Social, Puebla, Mexico, ³Inmunología y Reumatología, Universidad Autónoma de Puebla, Puebla, Mexico, ⁴Molecular Biology and Virology Laboratory, CIBIOR, Instituto Mexicano del Seguro Social, Puebla, Mexico, ⁵Research Coordination Delegation, Instituto Mexicano del Seguro Social, Puebla, Mexico, ⁶Systemic Autoimmune Disease Research Unit, HGR 36, Instituto Mexicano del Seguro Social, Puebla, Mexico, ⁷Department of Pathology, HGR 36, Instituto Mexicano del Seguro Social, Puebla, Mexico, ⁸State Research and Education Department, UMAE,Hospital de Especialidades, Instituto Mexicano del Seguro Social, Puebla, Mexico

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Human papillomavirus (HPV) and systemic lupus erythematosus (SLE)

Session Information

Date: Sunday, November 8, 2015

Title: Systemic Lupus Erythematosus - Clinical Aspects and Treatment Poster Session I

Session Type: ACR Poster Session A

Session Time: 9:00AM-11:00AM

Background/Purpose:

The risk of high-grade squamous intraepithelial lesions is significantly increased in SLE patients compared with healthy female controls. High-risk human papillomavirus infection (HR-HPV) is associated with the risk of cervical dysplasia and carcinoma. However, longitudinal studies analyzing HPV persistence in SLE women are limited. Our objective was to study the incidence, persistence, cumulative prevalence, and clearance of HPV infection in patients with SLE and to assess risk factors for the acquisition and persistence of HPV infection.

Methods:

Prospective, observational cohort study of 127 SLE women. Patients were evaluated at baseline and at 3 years. Traditional and SLE-related disease risk factors were collected. A gynaecological evaluation and cervical cytology screening were made. HPV detection and genotyping were made by PCR and linear array.

Results:

The cumulative prevalence of HPV infection increased significantly (22.8% at baseline vs. 33.8% at 3 years; p = < 0.001). With respect to type-specific HPV infection, 20.1% of patients experienced 42 incident infections. The risk of acquiring any HPV infection was 10.1 per 1000 patient-months. The cumulative prevalence of HR-HPV infection (19.6% at baseline vs. 29.1% at 3 years; p = 0.007) and multiple HPV infection (11.0% at baseline vs. 15.7% at 3 years; p = 0.03) also increased significantly. The most frequent newly-acquired HR types were HPV-16 (2.4 per 1000 patient-months) and 53 (1.4 per 1000 patient-months). Detection of the same type of HPV at two examinations occurred in only 6 (12.8%) of incident infections. At 3 years, 41 (87.2%) prevalent infections were cleared. Independent risk factors associated with incident HPV infection included higher number of lifetime sexual partners (OR= 1.8, 95% CI= 1.11-3.0) and cumulative cyclophosphamide dose (OR= 3.9, 95% CI= 1.2-12.8). Potential risk factors associated with persistent HPV infection included lupus activity at baseline (p = 0.03) pre-existing HVP infection (p = 0.008), and multiple HVP infection at baseline (p < 0.001). However, those possible associations were not confirmed when logistic multivariate analysis was performed.

Conclusion: In women with SLE, the cumulative prevalence of HPV infection, including HR-HPV and multiple HPV infections, increased significantly over time. Most persistent infections were LR-HPV. Number of lifetime sexual partners and cumulative cyclophosphamide dose were independently associated with incident HPV infection.

Disclosure: C. Mendoza Pinto, None; M. García-Carrasco, None; V. Vallejo-Ruiz, None; S. Méndez-Martínez, None; A. Taboada-Cole, None; J. L. Totolhua Ramírez, None; J. Reyes-Leyva, None; A. López-Colombo, None.

To cite this abstract in AMA style:

Mendoza Pinto C, García-Carrasco M, Vallejo-Ruiz V, Méndez-Martínez S, Taboada-Cole A, Totolhua Ramírez JL, Reyes-Leyva J, López-Colombo A. Incidence and Persistence of Cervical Human Papillomavirus Infection in Mexican Systemic Lupus Erythematosus Women [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/incidence-and-persistence-of-cervical-human-papillomavirus-infection-in-mexican-systemic-lupus-erythematosus-women/. Accessed .

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