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Prevalence of cervical human papillomavirus infection in women with systemic lupus erythematosus

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Abstract

Genital infection by human papillomavirus (HPV) tends to occur more frequently in patients with conditions associated with immune suppression. Systemic lupus erythematosus (SLE) is an immunological disorder characterized by generalized inflammation and a number of clinical manifestations and circulating autoantibodies. The aim of the present study was to determine the prevalence of genital HPV infection among female SLE patients. Women diagnosed with SLE based on American College of Rheumatology classification criteria followed at rheumatology outpatient clinic of the Escola Bahiana de Medicina e Saude Publica, Salvador, Brazil, were included in the study. As a comparison group, clinically healthy women who were attending the gynecology outpatient clinic for routine examination at the same institution were recruited. Testing for cervical HPV infection was performed using the nested polymerase chain reaction technique. Eighty-eight female SLE patients (mean age, 41.4 ± 11.6 years) and seventy healthy female subjects (control group) were studied. The prevalence of HPV infection was 80.7 % (71/88) in the SLE group and 35.7 % (25/70) in the control group (p < 0.0001). After adjustment of the variables (early sexual activity, number of partners and obstetric history), the odds ratio (OR) for genital HPV infection in women with SLE was 7.2 (95 % CI, 2.9 to 17.8; p = 0.0001). The use of immunosuppressive drugs was not associated with a higher prevalence of HPV infection. This study demonstrated that SLE patients have a higher prevalence of genital HPV infection, even when exposed to less potential risk factors for the virus.

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References

  1. Lizano M, Berumen J, Garcia-Carranca A (2009) HPV-related carcinogenesis: basic concepts, viral types and variants. Arch Med Res 40(6):428–434

    Article  PubMed  CAS  Google Scholar 

  2. Munoz N (2000) Human papillomavirus and cancer: the epidemiological evidence. J Clin Virol 19(1–2):1–5

    PubMed  CAS  Google Scholar 

  3. Veldhuijzen NJ, Snijders PJ, Reiss P, Meijer CJ, van de Wijgert JH (2010) Factors affecting transmission of mucosal human papillomavirus. Lancet Infect Dis 10(12):862–874

    Article  PubMed  Google Scholar 

  4. Grinsztejn B, Veloso VG, Levi JE, Velasque L, Luz PM, Friedman RK et al (2009) Factors associated with increased prevalence of human papillomavirus infection in a cohort of HIV-infected Brazilian women. Int J Infect Dis 13(1):72–80

    Article  PubMed  Google Scholar 

  5. Santana IU, Gomes AD, Lyrio LD, Rios Grassi MF, Santiago MB (2011) Systemic lupus erythematosus, human papillomavirus infection, cervical pre-malignant and malignant lesions: a systematic review. Clin Rheumatol 30(5):665–672

    Google Scholar 

  6. Ognenovski VM, Marder W, Somers EC, Johnston CM, Farrehi JG, Selvaggi SM et al (2004) Increased incidence of cervical intraepithelial neoplasia in women with systemic lupus erythematosus treated with intravenous cyclophosphamide. J Rheumatol 31(9):1763–1767

    PubMed  CAS  Google Scholar 

  7. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25(11):1271–1277

    Article  PubMed  CAS  Google Scholar 

  8. Solomon D, Davey D, Kurman R, Moriarty A, O’Connor D, Prey M et al (2002) The 2001 Bethesda system: terminology for reporting results of cervical cytology. JAMA 287(16):2114–2119

    Article  PubMed  Google Scholar 

  9. Richart RM (1990) A modified terminology for cervical intraepithelial neoplasia. Obstet Gynecol 75(1):131–133

    PubMed  CAS  Google Scholar 

  10. Demathe A, Bernabé DG, Garcia JF, Nunes CM, Miyahara GI (2010) Comparação entre dois métodos de detecção de DNA de papilomavírus humano em carcinoma epidermoide de lábio. J Bras Patol Med Lab 46:85–90

    CAS  Google Scholar 

  11. Tam LS, Chan AY, Chan PK, Chang AR, Li EK (2004) Increased prevalence of squamous intraepithelial lesions in systemic lupus erythematosus: association with human papillomavirus infection. Arthritis Rheum 50(11):3619–3625

    Article  PubMed  Google Scholar 

  12. Barros BRC, Matschinske R, Silva MB, Skare TL (2007) Prevalence of abnormal pap smears in patients with systemic lupus erythematosus. Rev Bras Reumatol 47(5):325–329

    Article  Google Scholar 

  13. Dhar JP, Kmak D, Bhan R, Pishorodi L, Ager J, Sokol RJ (2001) Abnormal cervicovaginal cytology in women with lupus: a retrospective cohort study. Gynecol Oncol 82(1):4–6

    Article  PubMed  CAS  Google Scholar 

  14. Nath R, Mant C, Luxton J, Hughes G, Raju KS, Shepherd P et al (2007) High risk of human papillomavirus type 16 infections and of development of cervical squamous intraepithelial lesions in systemic lupus erythematosus patients. Arthritis Rheum 57(4):619–625

    Article  PubMed  CAS  Google Scholar 

  15. Freitas TP, Carmo BB, Paula FD, Rodrigues LF, Fernandes AP, Fernandes PA (2007) Molecular detection of HPV 16 and 18 in cervical samples of patients from Belo Horizonte, Minas Gerais, Brazil. Rev Inst Med Trop Sao Paulo 49(5):297–301

    Article  PubMed  Google Scholar 

  16. Barber C, Gold WL, Fortin PR (2011) Infections in the lupus patient: perspectives on prevention. Curr Opin Rheumatol 23(4):358–365

    Article  PubMed  Google Scholar 

  17. Cuchacovich R, Gedalia A (2009) Pathophysiology and clinical spectrum of infections in systemic lupus erythematosus. Rheum Dis Clin North Am 35(1):75–93

    Article  PubMed  Google Scholar 

  18. Ramos-Casals M, Cuadrado MJ, Alba P, Sanna G, Brito-Zeron P, Bertolaccini L et al (2008) Acute viral infections in patients with systemic lupus erythematosus: description of 23 cases and review of the literature. Medicine (Baltimore) 87(6):311–318

    Article  Google Scholar 

  19. Pugliese A, Beltramo T, Torre D, Roccatello D (2007) Parvovirus B19 and immune disorders. Cell Biochem Funct 25(6):639–641

    Article  PubMed  CAS  Google Scholar 

  20. Aslanidis S, Pyrpasopoulou A, Kontotasios K, Doumas S, Zamboulis C (2008) Parvovirus B19 infection and systemic lupus erythematosus: activation of an aberrant pathway? Eur J Intern Med 19(5):314–318

    Article  PubMed  Google Scholar 

  21. Su BY, Su CY, Yu SF, Chen CJ (2007) Incidental discovery of high systemic lupus erythematosus disease activity associated with cytomegalovirus viral activity. Med Microbiol Immunol 196(3):165–170

    Article  PubMed  Google Scholar 

  22. Pope JE, Krizova A, Ouimet JM, Goodwin JL, Lankin M (2004) Close association of herpes zoster reactivation and systemic lupus erythematosus (SLE) diagnosis: case-control study of patients with SLE or noninflammatory nusculoskeletal disorders. J Rheumatol 31(2):274–279

    PubMed  Google Scholar 

  23. Kawashiri S, Nakamura H, Kawakami A, Ida H, Izumi Y, Tamai M et al (2006) Emergence of Epstein-Barr virus-associated haemophagocytic syndrome upon treatment of systemic lupus erythematosus. Lupus 15(1):51–53

    Article  PubMed  CAS  Google Scholar 

  24. Khamaganova IV (1992) Herpetic infection in patients with lupus erythematosus. Ter Arkh 64(11):121–123

    PubMed  CAS  Google Scholar 

  25. Nyberg G, Eriksson O, Westberg NG (1981) Increased incidence of cervical atypia in women with systemic lupus erythematosus treated with chemotherapy. Arthritis Rheum 24(5):648–650

    Article  PubMed  CAS  Google Scholar 

  26. Bateman H, Yazici Y, Leff L, Peterson M, Paget SA (2000) Increased cervical dysplasia in intravenous cyclophosphamide-treated patients with SLE: a preliminary study. Lupus 9(7):542–544

    Article  PubMed  CAS  Google Scholar 

  27. Kay S, Frable WJ, Hume DM (1970) Cervical dysplasia and cancer developing in women on immunosuppression therapy for renal homotransplantation. Cancer 26(5):1048–1052

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

M.S. receives a scholarship from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).

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The authors have no conflict of interest that is directly relevant to the content of this manuscript.

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Authors and Affiliations

  1. Escola Bahiana de Medicina e Saúde Pública, Rua Frei Henrique, 08, Nazaré, Salvador, Bahia, CEP 40000-000, Brazil

    Leomar D. C. Lyrio, Iuri U. Santana, Viviana G. Olavarria, Aline do N. Gomes, Licia CostaPinto, Rone Peterson C. Oliveira, Rita de Cássia R. Aquino & Mittermayer B. Santiago

  2. Centro de Pesquisa Gonçalo Moniz/Fundação Oswaldo Cruz, Salvador, Bahia, Brazil

    Maria Fernanda R. Grassi

  3. Serviços especializados em Reumatologia (SER) da Bahia, Salvador, Brazil

    Mittermayer B. Santiago

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  1. Leomar D. C. Lyrio
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  2. Maria Fernanda R. Grassi
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  3. Iuri U. Santana
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  4. Viviana G. Olavarria
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  5. Aline do N. Gomes
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  6. Licia CostaPinto
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  7. Rone Peterson C. Oliveira
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  8. Rita de Cássia R. Aquino
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  9. Mittermayer B. Santiago
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Correspondence to Mittermayer B. Santiago.

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Lyrio, L.D.C., Grassi, M.F.R., Santana, I.U. et al. Prevalence of cervical human papillomavirus infection in women with systemic lupus erythematosus. Rheumatol Int 33, 335–340 (2013). https://doi.org/10.1007/s00296-012-2426-0

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  • DOI: https://doi.org/10.1007/s00296-012-2426-0

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