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

Abstract

OBJECTIVE:To identify the prevalence and factors associated with cervical human papillomavirus infection in women with systemic lupus erythematosusMETHODS:This cross-sectional study collected traditional and systemic lupus erythematosus-related disease risk factors, including conventional and biologic therapies. A gynecological evaluation and cervical cytology screen were performed. Human papillomavirus detection and genotyping were undertaken by PCR and linear array assay.RESULTS:A total of 148 patients were included, with a mean age and disease duration of 42.5±11.8 years and 9.7±5.3 years, respectively. The prevalence of squamous intraepithelial lesions was 6.8%. The prevalence of human papillomavirus infection was 29%, with human papillomavirus subtype 59 being the most frequent. Patients with human papillomavirus were younger than those without the infection (38.2±11.2 vs. 44.2±11.5 years, respectively; p = 0.05), and patients with the virus had higher daily prednisone doses (12.8±6.8 vs. 9.7±6.7 mg, respectively; p = 0.01) and cumulative glucocorticoid doses (14.2±9.8 vs. 9.7±7.3 g, respectively; p = 0.005) compared with patients without. Patients with human papillomavirus infection more frequently received rituximab than those without (20.9% vs. 8.5%, respectively; p = 0.03). In the multivariate analysis, only the cumulative glucocorticoid dose was associated with human papillomavirus infection.CONCLUSIONS:The cumulative glucocorticoid dose may increase the risk of human papillomavirus infection. Although rituximab administration was more frequent in patients with human papillomavirus infection, no association was found. Screening for human papillomavirus infection is recommended in women with systemic lupus erythematosus.

Risk of severe herpes simplex virus infection in systemic lupus erythematosus: analysis of epidemiology and risk factors analysis in Taiwan

“…Among all immunosuppressants, our study found that only steroid use—including intravenous administration and a daily oral dose of over 7.5 mg—represented an independent risk factor for severe HSV infection. Several studies have referred to systemic glucocorticoid as a risk factor for SLE infection through many pathogens, including bacteria, fungi and viruses 20–22. Among viruses, systemic steroid use has been associated with HZV,23 human papillomavirus21 and human cytomegalovirus,24 whereas little attention has been given to HSV.…”

Giant Condyloma Acuminata in Indonesian Females with SLE under Immunosuppressant and Steroid Therapy

“…In addition to SLE (OR 2.16, 95% CI 1.04–4.48) [13]. Mendoza-Pinto et al [17] found that cumulative glucocorticoid dose in women with SLE may increase the risk of HPV infection. Glucocorticoid such as prednisone suppressed the functions of Toll-like receptor (TLR) stimulated plasmacytoid dendritic cells, thereby reducing the ability to clear HPV infection.…”

Vaccination in rheumatology (the 2019 update of EULAR recommendations)

“…Инфекция, вызванная ВПЧ, при СКВ встречается чаще (12-30%), чем при других ИВРЗ [60]. Установлено, что наличие СКВ само по себе является независимым предиктором развития ВПЧ-инфекции, повышая риск последней в 2,2-2,7 раза [63,64]. В ряде исследований выявлена взаимосвязь нарастающей распространенности ВПЧ при СКВ с применением высоких кумулятивных доз ГК, а также азатиоприна и циклофосфамида [64][65][66].…”

“…Установлено, что наличие СКВ само по себе является независимым предиктором развития ВПЧ-инфекции, повышая риск последней в 2,2-2,7 раза [63,64]. В ряде исследований выявлена взаимосвязь нарастающей распространенности ВПЧ при СКВ с применением высоких кумулятивных доз ГК, а также азатиоприна и циклофосфамида [64][65][66]. В ходе крупных популяционных исследований показана высокая иммуногенность и безопасность ВПЧ-вакцины у девушек и женщин с фоновыми аутоиммунными заболеваниями.…”