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The prevalence of human papillomavirus (HPV) type 16 infection, and consequent cervical squamous intraepithelial lesions, appear to be increased in women with systemic lupus erythematosus (SLE), according to UK researchers.
"Clinicians dealing with SLE patients should be aware that they are at very high risk of developing cervical abnormalities and pre-cancers," senior investigator Dr. John Cason told Reuters Health. This is particularly so, he added, "within the first five years of diagnosis."
In the May 15th issue of Arthritis and Rheumatism, Dr. Cason of King's College, London and colleagues report on their study of 30 women with SLE, 67 women with abnormal smears from colposcopy clinics, and 15 community-dwelling women with normal smears.
Fifty-four percent of SLE patients and 67% of colposcopy patients were HPV positive and 57% of the SLE group were HPV-16 DNA positive. This was true of only 31% of colposcopy patients, a significant difference.
None of the women with normal smears was HPV positive and only 1 (6%) was HPV-16 DNA positive.
SLE patients with a high HPV-16 viral load more frequently had squamous intraepithelial lesions (SIL). Six of those sampled had SIL, compared to only one SLE patient with a low HPV-16 viral load.
At the time of study, five SLE patients (17%) had an abnormal cervical smear and eight patients (27%) had SIL. The rate of SIL was 44% lower in those with SLE diagnosed more than 10 years earlier, compared to those who had had such a diagnosis for less than 5 years (odds ratio, 0.56).
Overall, the reason for these findings "is not yet clear," continued Dr. Cason, but it could be related to "drug therapy or some other feature of the disease."
Nevertheless, he and his colleagues recommend that women with SLE "should be investigated regularly for cervical abnormalities, particularly within the first 5 years after SLE diagnosis."
Arthritis Rheum 2007;57:619-625.
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