Prevalência da infecção anogenital pelo papilomavírus humano (HPV) em usuários de terapia imunobiológica

Abstract

Introduction: Patients using immunobiological drugs are at increased risk of presenting or reactivating latent or occult infections and unnoticed neoplasms. Screening prior to the use of these drugs includes warding off infections, including tuberculosis, viral hepatitis B and C, syphilis, human immunodeficiency virus (HIV), and opportunistic pathogens in immunosuppressed patients. However, human papillomavirus (HPV), a highly prevalent agent in our country and precursor of benign or even carcinogenic warts, is not routinely screened. Information on HPV infection in immunobiological users is scarce or conflicting, and there are no studies evaluating the prevalence of HPV in the anogenital region among users of different classes of these medications for the treatment of different immunomediated chronic inflammatory diseases, when compared to that of non-users of this medication. Objective: To compare the prevalence of anogenital HPV infection in immunobiological users for the treatment of immunomediated chronic inflammatory diseases with that of non-users of this medication. Materials and methods: HPV positivity in 114 immunobiological users (infliximab, etanercept, adalimumab, secuquinumab and ustequinumab) were evaluated clinically and by polymerase chain reaction (PCR) for the treatment of immunomediated chronic inflammatory diseases (psoriasis, psoriatic arthritis, suputive hydrosadenitis, rheumatoid arthritis, ankylosing spondylitis and Chron's disease) and 114 individuals not using this therapy or other immunosuppressants, with dermatoses, except psoriasis, and not carriers of conditions predisposing to HPV infection (diabetes mellitus, hematological diseases, HIV infection, hepatitis B or C, neoplasms and organ transplants). Results: The prevalence of low-risk HPV in the immunobiological users and non-users groups was 16.3% and 10.3%, respectively (p= 0.524). The low-risk types found were 6, 11, 40, 42 and 44. The prevalence of high-risk HPV was 20.2% in users versus 18.4% in non-users (p= 0.737), distributed according to the following types: 16 (6.8%); 18 (11.4%); not 16/18 (81.8%). After pairing by gender and age, the prevalence of high-risk HPV was 21.0% and 12.9% for immunobiological users and non-users, respectively (p= 0.231). Separating by class of immunobiologicals, the prevalence of high-risk HPV among users of anti-TNF-α was 20.0% and anti-IL 21.6%, with no significant association (p= 0.482). Thus, there was no association between both groups and the prevalence of low-risk or high-risk HPV. Conclusion: The prevalence of anogenital HPV infection in patients with chronic immune-mediated inflammatory diseases treated with immunobiologicals is similar to that of patients not using these drugs.