Abstract
Background: The primary objective of this work was to assess the prevalence and distribution of HPV genotypes in immunosuppressed patients, and to compare them with the French Monsonego cohort. Secondary objectives were to evaluate whether the risk of HPV infection was correlated with HIV viral load, CD4 cell count in HIV-infected patients and the type, number of immunosuppressive therapies or type of pathology (transplant vs. autoimmune diseases) in patients undergoing long-term immunosuppressive therapy. Methods: An observational, monocentric and historical study was conducted including all immunosuppressed patients having received an HPV testing, in the Laboratory of Virology, Nancy Regional Teaching Hospital Center, between 2014 and 2020. Immunosuppressed patients were either HIV-infected or received long-term immunosuppressive therapy. Results: In our cohort, the prevalence of HPV infection (75.6% vs. 16.1% p < 0.05), the proportion of patients with high-risk HPV infection (48.9% vs. 15.1% p < 0.05) and with multiple HPV infection (41.1% vs. 5.7% p < 0.05) were significantly higher than in the Monsonego cohort. HPV 52 (13%), 53 (13%) and 16 (10%) were the most common in the immunosuppressed population, while it was HPV 16, 42 and 51 in the Monsonego cohort. Conclusions: This study supports that a particular attention must be given to all the immunosuppressed patients for the screening and care of HPV-related diseases because of major modifications of HPV epidemiology compared with the overall population.
Highlights
Immunosuppressed population includes HIV-infected patients, transplant patients and those affected by long-term immunosuppressive therapy for autoimmune diseases.In France, 173,000 people are living with HIV [1]
Infection reached 75.6% compared to 16.1% in the French Monsonego cohort (p < 0.05)
This French cohort was the most representative of the overall French population because a large number of women (5002) were included after consulting for an undergoing routine check. The characteristics of this population were close to those of our immunosuppressed population: no women were vaccinated, 10.3% of the patients were less than 25 years old (6.7% in our study) and 23.5% of the patients smoked (24.4% in our study)
Summary
Immunosuppressed population includes HIV-infected patients, transplant patients and those affected by long-term immunosuppressive therapy for autoimmune diseases. In France, 173,000 people are living with HIV (human immunodeficiency virus) [1]. In. 2018, after several years of stagnation a slight decrease was noted in the number of people discovering their seroconversion [1]. The number of transplants in France has regularly increased, notably between 2018 and 2019 with a rise of 1.6% [2]. Sixty-thousand people are currently living with a transplanted organ in France. Ten percent of industrialized countries populations are affected by autoimmune diseases and this number has been constantly rising over the last few decades [3]
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