Cervical Health in Systemic Lupus Erythematosus

Area of Science:

• Immunology
• Gynecology
• Public Health

Background:

• African American (AA) women with systemic lupus erythematosus (SLE) experience a health disparity with increased prevalence of human papilloma virus (HPV) infection and cervical neoplasia.
• Cervical cancer screening and HPV prevention are critical for this high-risk population.

Purpose of the Study:

• To assess cytology, HPV infection, and vaginal cytokine production in AA women with SLE using a self-sampling brush.
• To evaluate cervical health knowledge and risk factors for HPV infection in this cohort.

Main Methods:

• Thirty AA women with SLE (ages 18-50) provided cervical cells via self-sampling for cytology, HPV DNA/RNA, and vaginal cytokine RNA analysis.
• Clinical data and cervical health history were collected through record review, interviews, and surveys, including HPV knowledge and self-sampling satisfaction.

Main Results:

• The cohort (mean age 36.9) had moderate/severe SLE on immunosuppressives, with 63% having a history of abnormal Pap smears.
• High-risk factors for HPV were prevalent: 83.3% unvaccinated for HPV, 73.3% not using condoms, 9.5±7 sexual partners, and 26.7% smoking.
• 13.3% had abnormal cytology, 70% tested HPV DNA-positive (often multiple types), and all showed active HPV infection (+RNA) with varied cytokine expression.

Conclusions:

• AA women with SLE in this study demonstrated significant gaps in knowledge regarding HPV-related diseases and risk reduction strategies.
• The findings underscore the urgent need for enhanced cervical health education, increased monitoring, and targeted interventions for this vulnerable population.