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Lack of Uptake of Prophylactic Human Papilloma Virus Vaccine Among Women With Systemic Lupus Erythematosus Seen at a Regional Medical Center

Dhar, Josephine Patricia MD*; Essenmacher, Lynnette MS*; Dhar, Renee MD; Ragina, Neli PhD; Sokol, Robert J. MD*

JCR: Journal of Clinical Rheumatology: December 2019 - Volume 25 - Issue 8 - p 348–350
doi: 10.1097/RHU.0000000000000866
Concise Report

Background/Objective Women with systemic lupus erythematosus (SLE) are at increased risk for cervical neoplasia likely due to infection with high-risk human papillomavirus (HR-HPV) and should be considered for HPV vaccination. We sought to determine the frequency of HR-HPV infection and uptake of HPV vaccination in our regional female lupus population.

Methods For this medical records review study, data were analyzed from our electronic health records EPIC for women with International Classification of Diseases-10 or International Classification of Diseases -9 billing codes for SLE seen June 6, 2007, to May 1, 2017. This study was approved by the Central Michigan University/Covenant Medical Center institutional review board. Statistical analyses consisted of Student t test, χ2, and Z test for proportions using SPSS v. 24 software.

Results A total of 1349 women with SLE were identified, mean age of 53 years, 70.8% white, 20.8% African American, with 49% exposed to cigarette smoke. High-risk HPV testing performed in 195 (14.5%; mean age, 50 years) showed 16.9% (33/195) were positive, with those testing positive for HR-HPV being slightly younger (p < 0.05).

Comparing our proportion testing positive for HR-HPV (0.169) versus National Health and Nutrition Examination Survey (0.088), we calculated a Z = 3.99 (p < 0.001) indicating HPV infection is significantly higher (2×) in our female SLE cohort. Only 16.0% (38/238) of the 238 women eligible to receive an HPV vaccine were tested for HR-HPV with 9 being positive and only 4.6% (11/238) vaccinated.

Conclusions Human papillomavirus infection is a serious health issue in women with SLE, but HPV testing and vaccination rates remain low. Efforts should be directed to promote awareness of the importance of HPV vaccination in this high-risk population.

From the *Wayne State University, Detroit

Central Michigan University College of Medicine, Mt Pleasant, MI.

The authors declare no conflict of interest.

Correspondence: Josephine Patricia Dhar, C.S. Mott Center for Human Growth and Development, c/o Vicki Perry, first floor, 275 E Hancock, Detroit, MI 48201. E-mail:

Online date: July 20, 2018

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