TOPLINE:

Women with systemic lupus erythematosus (SLE) on immunosuppressive therapy had a higher likelihood of human papillomavirus (HPV) seropositivity and cervical lesions than immunocompetent women.

METHODOLOGY:

• Researchers conducted a cross-sectional study at a hospital in São Paulo, Brazil, from July 2017 to October 2018, enrolling 122 women with SLE (mean age, 34.4 years) who received disease-modifying antirheumatic drugs or immunosuppressive therapy and 132 immunocompetent women (mean age, 32.5 years).
• Cervical samples were tested for the presence of HPV DNA (detecting 26 types of HPV: 12 high risk and 14 low risk) and squamous intraepithelial lesions; serum samples were analyzed for antibodies against HPV types using a pseudovirion-based serology assay.
• The between-group differences in the seroprevalence of HPV, prevalence of cervical HPV DNA, and frequency of HPV-related cytological lesions, as well as the associations between SLE status and cervical cytological lesions, positivity for cervical HPV DNA, and HPV seropositivity, were assessed.

TAKEAWAY:

• Women with SLE had a higher prevalence of combined low-grade and high-grade squamous intraepithelial lesions than immunocompetent women (11.3% vs 2.4%; P = .009) and higher odds of cervical cytological lesions (adjusted odds ratio [aOR], 6.62; P = .008).
• Positivity for cervical HPV DNA for at least one type of HPV was higher in participants with SLE than in immunocompetent women (38.8% vs 20.2%; P = .003), and women with SLE had higher odds of cervical HPV infection (aOR, 2.36; P = .017).
• Seropositivity for at least one type of HPV was higher in women with SLE (80.4% vs 59.7%; P = .001), with increased odds noted for HPV seropositivity (aOR, 2.58; P = .008).
• Among women with SLE, current use of mycophenolate mofetil was independently associated with increased odds of cervical lesions (aOR, 5.08; P = .015) and cervical HPV positivity (aOR, 2.43; P = .048).

IN PRACTICE:

“Our findings underscore the need for disease-specific preventive care protocols for women with SLE. Strengthening adherence to SLE-specific screening guidelines, expanding coverage of adolescent vaccination, and implementing targeted multiage catch-up strategies for unvaccinated high-risk immunocompromised women are essential measures,” the authors of the study wrote.

SOURCE:

The study was led by Vanessa Infante, MD, Universidade de São Paulo, São Paulo, Brazil. It was published online on April 9, 2026, in Lupus Science & Medicine.

LIMITATIONS:

The cross-sectional study design limited causal inference because it cannot establish temporality between SLE status and HPV outcomes and did not allow assessment of HPV persistence. The sample size may have been underpowered to detect differences in prevalence of high-risk HPV or cytological lesions between groups. The comparator group consisted mainly of hospital staff, who may have socioeconomic and behavioral differences compared with the SLE group.

DISCLOSURES:

The study received support from the São Paulo Research Foundation. No relevant conflicts of interest were declared by the authors.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.