Systemic Lupus Erythematosus, Human Papilloma Virus Infection and Vaccine

Human papilloma virus(HPV)can cause pre-malignant cervical abnormalities and cervical cancer as well as benign conditions such as anogenital warts, especially serotype 16 and 18, which were closely associated with cervical cancer. The prevalence of HPV infection and multiple HPV infections in patients with systemic lupus erythematosus(SLE) is higher than general population, and the risk of abnormal Pap smears and cervical high grade intraepithelial lesions are significantly increased. It is very important to prevent HPV infection in patients with SLE. Vaccine is one of the most effective tools to prevent the infectious diseases. Three non-live protein subunit vaccines for HPV were approved in the last decade:bivalent(HPV 16, 18), quadri-valent(HPV 6, 11, 16, 18), and 9 valent(HPV 6, 11, 16, 18, 31, 33, 45, 52, 58) vaccines. These vaccines were developed to prevent pre-malignant cervical and cervical cancer. qHPV and 9 valent vaccines also prevent benign conditions caused by HPV, such as anogenital warts. Multiple prospective studies showed HPV vaccines were safe and efficacious in patients with SLE, and protective immune response could be produced. In 2019 update of EULAR recommendations for vaccination in adult patients with autoimmune inflammatory rheumatic diseases(AⅡRD), it is recommended that patients with AⅡRD, in particular patients with SLE, should receive vaccinations against HPV in accordance with recommendations for the general population.