Evaluation of High Risk HPV (HPV-16 and -18) RNA and Integration in Cervical Neoplasms in Systemic Lupus Erythematosus

Objective: To determine frequency, transcription and integration rates for high risk Human papillomavirus (HR HPV) types 16 and 18 in neoplastic cervical tissue of women with systemic lupus erythematosus (SLE). Methods: Cervical tissue of cervical intraepithelial neoplasia 1 (CIN 1) or greater severity were obtained from 112 women with SLE. HPV typing and integration was assessed by polymerase chain reaction (PCR) using primers specific for HPV 16 and 18 located in the open reading frames E7, E2, and E5. A commercially available kit was employed for transcriptional analysis of samples positive for HPV DNA types 16 or 18. Results: For the 112 SLE patients, 80.3% of the cervical biopsies were CIN 1 or CIN2 , 15.2% CIN 3, and 4.5% carcinoma in situ/ invasive cancer. HPV DNA 16 and 18 were detected in 20.5%, mostly type 16. Low integration and transcription rates were seen. There was no association of disease severity or immunosuppressive drugs with the presence of HPV DNA or RNA. Conclusion: The paucity of HR HPV along with lack of detectable viral transcripts, are unexpected findings and suggest HPV is latent in CIN lesions in SLE. Host- HPV interactions in this group of immunosuppressed women warrant further study.