Prevalence of Chlamydia trachomatis endocervical infection in systemic lupus erythematosus patients and evaluation of the risk for HPV-induced lesions

Abstract

Chlamydia trachomatis (CT) is the most common bacterial cause of sexually transmitted disease. It has been associated with arthritis and it is a risk factor for human papillomavirus (HPV)-induced lesions. There are few studies on the frequency of CT infection among systemic lupus erythematosus (SLE) patients. The aim of this study was to determine the prevalence of endocervical CT infection among SLE patients and evaluate whether or not CT infection is a risk factor for HPV-induced lesions. A cross-sectional study included a group of patients who fulfilled the American College Rheumatology criteria for a definite diagnosis of SLE and a control group of non-SLE female individuals from Bahia, Brazil. Polymerase chain reaction was used on endocervical swab specimens to test for CT; a gynecological examination including a cervical cytology and biopsy was done for the identification of HPV lesions. A total of 105 SLE patients were studied, and the control group was composed of 104 age-matched apparently normal women. The prevalence of CT endocervical infection was 3.0 % [confidence interval (CI) 95 % = 0.6-8.0 %] in the SLE group and 5.0 % (95 % CI = 2.0-11.0 %) in the control group; the prevalence ratio was 0.60 (95 % CI = 0.1-2.5). The prevalence of vulvar condyloma was higher among SLE patients (11.0 vs. 1.0 %, p \ 0.001), as were the prevalences of low-grade lesion (12.0 vs. 1.0 %, p \ 0.001) and cervical intraepithelial neoplasia 1 (9.0 vs. 1.0 %, p = 0.02). There was no association between the presence of HPV lesions and CT infections. However, the small number of patients with CT prevents a definite conclusion from being drawn. The prevalence of endocervical CT infection in women with SLE is low and similar to that of the normal population. This suggests that this infection has no role in the pathogenesis of SLE or the development of HPV-induced lesions.

The impact of glucocorticoids and anti-cd20 therapy on cervical human papillomavirus infection risk in women with systemic lupus erythematosus

“…Rojo-Contreras et al (5) recently found a prevalence of 14.7% in Mexican SLE patients. In contrast, a Brazilian study found a prevalence of 80.7% (9). These differences may be due to environmental, cultural, or genetic risk factors or geographical variations (23).…”

“…However, some studies have found no association between cervical HPV infection and immunosuppressive therapy (3,9). In recent years, new, targeted therapies have been administered to SLE patients, and there has been some evidence for the efficacy and safety of B cell depletion by anti-CD20 therapy with rituximab.…”

Antibodies toChlamydia trachomatisand reproductive health issues in women with SLE: a case–control study

“… 18 A study assessed C. trachomatis by vaginal swab test and did not find an increased prevalence in patients with SLE. 32 Another study investigated the potential relationship between coronary calcifications as a marker of atherosclerotic burden and PCR for C. pneumonia e and C. trachomatis in the peripheral blood monocytes of patients with SLE, without finding a clear association. 33 Most patients with SLE included in our study had disease features beyond articular and cutaneous involvement.…”

Association between systemic lupus erythematosus and risk of cervical atypia: A meta-analysis

“…The characteristics of the patients are shown in Table 1. There were eight studies 8,19,24,26,27,[29][30][31] focused on cervical cancer, seven studies 2,10,20,22,23,25,33 on squamous intraepithelial lesion (SIL) and six studies 10,20,22,23,25,33 approaching risk of lowgrade SIL (LGSIL).…”