Abstract

Systemic lupus erythematosus (SLE) is considered one of the risk factors for cervical cytological abnormalities and high-risk HPV infection. However, there is a scarcity of data about the prevalence of high-risk HPV infection in patients with lupus. In order to define strategies for cancer prevention, we aimed to determine the prevalence of HPV infections in women with SLE compared to a control group. Fifty patients with SLE from the SLE clinic in Hafez Hospital, Shiraz University of Medical Sciences, were compared to 50 healthy married control women. In both groups, routine Pap smears were obtained, and the endocervical side of the spatula was sent for HPV DNA analysis. The case and control groups were compared for the presence and type of HPV infection as well as the relation between its presence with immunosuppressant use and disease activity. HPV infection was detected in 4% (2.50) of lupus patients, but it was not seen in the control group. HPV typing identified types 16 and 18 in these two patients. No relationship between HPV infection and immunosuppressant use or activity of disease was seen in the current study. There was no statistically significant difference in HPV prevalence between patients and the control group (P=0.495). Results of this study showed that SLE and the use of immunosuppressants in patients with lupus were not risks for high-risk HPV infection or cervical dysplasia in our area compared to the normal population, but further studies on more patients receiving immunosuppressants and biologics are recommended.

Highlights

  • Systemic lupus erythematosus (SLE) is a disease caused by an abnormal autoimmune response, and anti-inflammatory and/or immunosuppressive drugs are needed for its treatment [1]

  • human papillomavirus (HPV) DNA is present in 80% to 90% of squamous cell carcinomas and adenocarcinomas of the cervix worldwide; it is found in cervical intraepithelial neoplasia (CIN)

  • Some studies have reported that the rate of cervical dysplasia as a result of the presence of high-risk HPV was increased in woman with lupus; the increased prevalence of HPV may be due to exposure to immunosuppressive drugs like cyclophosphamide [4]

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Summary

Introduction

Systemic lupus erythematosus (SLE) is a disease caused by an abnormal autoimmune response, and anti-inflammatory and/or immunosuppressive drugs are needed for its treatment [1]. HPV DNA is present in 80% to 90% of squamous cell carcinomas and adenocarcinomas of the cervix worldwide; it is found in cervical intraepithelial neoplasia (CIN). Some studies have reported that the rate of cervical dysplasia as a result of the presence of high-risk HPV was increased in woman with lupus; the increased prevalence of HPV may be due to exposure to immunosuppressive drugs like cyclophosphamide [4]. It was not clear whether these associations were host-related, disease-related, or, alternatively, related to drug effects [5]

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