title: Incidence of cervical human papillomavirus infection in systemic lupus erythematosus women.
abstract: Objectives Our objective was to study the incidence, persistence and clearance of human papillomavirus infection in systemic lupus erythematosus women and assess risk factors for persistence of human papillomavirus infection. Methods We carried out a prospective, observational cohort study of 127 systemic lupus erythematosus women. Patients were evaluated at baseline and at three years. Traditional and systemic lupus erythematosus women-related disease risk factors were collected. Gynaecological evaluations and cervical cytology screening were made. Human papillomavirus detection and genotyping were made by polymerase chain reaction and linear array. Results The cumulative prevalence of human papillomavirus infection increased from 22.8% at baseline to 33.8% at three years; p = < 0.001: 20.1% of patients experienced 43 incident infections. The risk of any human papillomavirus infection was 10.1 per 1000 patient-months. At three years, 47 (88.6%) prevalent infections were cleared. Independent risk factors associated with incident human papillomavirus infection included more lifetime sexual partners (odds ratio = 1.8, 95% confidence interval = 1.11-3.0) and cumulative cyclophosphamide dose (odds ratio = 3.9, 95% confidence interval = 1.2-12.8). Conclusions In systemic lupus erythematosus women, the cumulative prevalence of human papillomavirus infection, including high risk-human papillomavirus and multiple human papillomavirus infections, may increase over time. Most persistent infections were low risk-human papillomavirus. The number of lifetime sexual partners and the cumulative cyclophosphamide dose were independently associated with incident human papillomavirus infection.
authors.affiliation: 1 Systemic Autoimmune Diseases Research Unit, HGR 36-CIBIOR, Instituto Mexicano del Seguro Social, Puebla, México.|2 Department of Immunology and Rheumatology, Benemérita Universidad Autónoma de Puebla, México.
authors.forename: C
authors.initials: C
authors.lastname: Mendoza-Pinto
authors.affiliation: 1 Systemic Autoimmune Diseases Research Unit, HGR 36-CIBIOR, Instituto Mexicano del Seguro Social, Puebla, México.|2 Department of Immunology and Rheumatology, Benemérita Universidad Autónoma de Puebla, México.
authors.forename: M
authors.initials: M
authors.lastname: García-Carrasco
authors.affiliation: 3 Molecular and Virology Laboratory, CIBIOR, Instituto Mexicano del Seguro Social, Metepec, Puebla, México.
authors.forename: V
authors.initials: V
authors.lastname: Vallejo-Ruiz
authors.affiliation: 4 State Research Department, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: S
authors.initials: S
authors.lastname: Méndez-Martínez
authors.affiliation: 5 Department of Obstetrics and Gynecology, HGR 36, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: A
authors.initials: A
authors.lastname: Taboada-Cole
authors.affiliation: 1 Systemic Autoimmune Diseases Research Unit, HGR 36-CIBIOR, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: I
authors.initials: I
authors.lastname: Etchegaray-Morales
authors.affiliation: 6 Secretary of Research and Postgraduate Studies, Benemérita Universidad Autónoma de Puebla, México.
authors.forename: M
authors.initials: M
authors.lastname: Muñóz-Guarneros
authors.affiliation: 3 Molecular and Virology Laboratory, CIBIOR, Instituto Mexicano del Seguro Social, Metepec, Puebla, México.
authors.forename: J
authors.initials: J
authors.lastname: Reyes-Leyva
authors.affiliation: 7 State Research and Education Department, Instituto Mexicano del Seguro Social, Puebla, México.
authors.forename: A
authors.initials: A
authors.lastname: López-Colombo
mesh_terms: D000328:Adult; D003520:Cyclophosphamide / Q000009:adverse effects; D005260:Female; D005838:Genotype; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D015994:Incidence; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000453:epidemiology / Q000401:mortality / Q000821:virology; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology* / Q000821:virology; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012747:Sexual Partners; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000821:virology*; D014626:Vaginal Smears / Q000379:methods
chemical_list: D007166:Immunosuppressive Agents; D003520:Cyclophosphamide
keywords: Systemic lupus erythematosus; human papillomavirus infection; incidence; prognosis; risk factors