Human papillomavirus (HPV) and cervical dysplasia in adult female cystic fibrosis (CF) lung transplant recipients

Abstract

Human papillomavirus (HPV) is the principal risk factor for cervical cancer. Transplant recipients are at a disproportionate risk of HPV complications. We conducted a single-centre, retrospective study of adult female cystic fibrosis (CF) lung transplant recipients between 2008 and 2021. We observed 12 of 34 (35.3%) with ≥1 abnormal pap smear (median age: 26.7 years). Complications included refractory anogenital warts (n=3), vulvectomy (n=2) and cervical cancer (n=4), with two deaths from metastatic disease. None with HPV morbidity was vaccinated. Lung transplant recipients had greater odds of cervical dysplasia relative to controls (OR, 3.98; 95% CI 1.17 to 11.82). CF care providers must prioritise HPV vaccination to attenuate potential future morbidity and mortality.

Prevalence and correlates of Human Papillomavirus infection in females from Southern Province, Zambia: A cross-sectional study

“…Majority of the participants were WLWH, indicating the importance of studying HPV infection in this particular group. It is well-established that individuals with compromised immune systems, such as WLWH, are at a higher risk of acquiring HPV infection and developing associated complications, including cervical cancer [ 1 , 50 – 52 ]. By including a substantial number of WLWHIV in our study, we have shed light on an important aspect of HPV epidemiology within the Zambian context.…”

Prevalence and correlates of Human Papillomavirus infection in females from Southern Province, Zambia: A cross-sectional study

“…The majority of the participants were WLWH, indicating the importance of studying HPV infection in this particular group. It is well-established that individuals with compromised immune systems, such as WLWH, are at a higher risk of acquiring HPV infection and developing associated complications, including cervical cancer 1,51–53 . By including a substantial number of WLWHIV in our study, we have shed light on an important aspect of HPV epidemiology within the Zambian context.…”

HPV-associated complications post lung transplantation: why prevention is better than ‘no’ cure

“…But it also brings new challenges and burdens, including ongoing commitment to intensive follow-up and demanding drug regimens with a range of new adverse effects. Thornton et al have highlighted an important but perhaps overlooked consequence of the immune suppression necessary after lung transplantation—that of cervical dysplasia caused by human papilloma virus (HPV) 1. In a single-centre retrospective study, they reported high rates of HPV-associated morbidity in women with CF who had undergone lung transplant, and a 4 x greater risk of cervical dysplasia compared with non-transplanted CF controls.…”