Women with lupus demonstrate low HPV vaccination rates, high infection rates
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PHILADELPHIA — Among women with systemic lupus erythematosus, just 3.7% are vaccinated for HPV, while nearly 30% demonstrate HPV infection, according to data presented at ACR Convergence 2022.
“We were trying to study and explore whether the current guidelines for cervical cancer screening meet the needs of our SLE patients,” Zehra Kazmi, MD, a fellow at the University of Texas Health San Antonio, told attendees.
To examine HPV vaccination and infection, as well as Pap smear cytology, in patients with SLE, Kazmi and colleagues conducted a retrospective cohort study spanning from May 2020 through May 2022. To be included in the analysis, patients were required to have visited the lupus clinic at UT Health San Antonio during the study period. Additionally, participants were required to be women aged 21 to 65 years and have undergone at least one Pap smear since receiving a diagnosis for SLE, according to Kazmi. Patients were excluded if they had undergone a hysterectomy.
Researchers collected and analyzed data including HPV vaccination status, Pap smear cytology results and results of HPV tests performed since 2011. Patients who underwent Pap smears, but not HPV testing, were also included in the analysis, Kazmi said. Patients were categorized and analyzed in three age groups. The first group included patients aged 21 to 26 years, the second collected patients aged 27 to 45 years, and the third collected patients aged 45 years and older.
The analysis included 106 patients with SLE, of whom 3.7% had been vaccinated for HPV. Pap smear results were “abnormal” in 24% of patients, and 29.7% of the participants tested positive for HPV. The infection rate was higher in younger age groups, with 83% of patients in the youngest group testing positive, compared with 35% of patients in the middle group (P < .009). In addition, 35% of patients in the middle group tested positive, compared with 0% in the oldest group (P < .0005). Among patients who tested positive for HPV, 40% of those in the youngest group, and 56.5% those in the middle group, demonstrated persistent infection.
“In conclusion, the present guidelines do not recommend co-testing for HPV in SLE patients younger than 30 years,” Kazmi said. “However, our data suggests that there is high rate of persistent HPV infection in this age group.”
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Kazmi Z. Abstract 1671. Presented at: ACR Convergence 2022; Nov. 11-14, 2022; Philadelphia (hybrid meeting).
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