P-14 CERVICAL DYSPLASIA AND RISK FACTORS IN NORTHERN IRELAND SLE PATIENTS

Introduction: An increased risk of cervical dysplasia has previously been reported in lupus. The role of traditional related risk factors are unclear. Persistent infection with certain genotypes of Human Papilloma Virus termed high risk (HR-HPV) is considered a prerequisite for the development of cervical cancer. Methods: A total of 141 SLE patients fulfilling the ACR criteria for lupus were enrolled into the study. They were compared to 138 control patients who were due to attend for a routine cervical smear. Each patient completed a cervical cancer risk factor questionnaire. A cervical smear was taken and residual material used to test for the presence of HR-HPV using a hybridisation microplate assay. Positive samples were then genotyped. Results:  VARIABLE RR (95% CI) P value Ever conceived 2.52 (1.37–4.64) P = 0.003 >1 sexual partner 3.46 (2.03–5.91) P < 0.001 Age sexual active 0.98 (0.92–1.04) NS Smoking history 1.10 (0.64–1.90) NS STD 0.52 (0.20–1.40) NS SLE patients in this study had an increased lifetime occurrence of an abnormal cervical smear. Although a similar detection rate of HR-HPV positivity was found in SLE (15.6%) and control women (17.4%), the mean age of the SLE HPV+ women was 43 years compared with 30 years for the HPV+ controls Co- Variate Analysis of traditional risk factors Discussion: Parity and number of sexual partners may be important traditional risk factors. HPV positive SLE patients tend to be older. HR-HPV may represent an opportunistic infection in these women as in other immunosuppressed disease states. Genotyping results suggest the same HPV types as non-SLE women and no single type predominated.