Background Growing evidence demonstrates the role of vitamin D deficiency in infections. Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that has been linked to vitamin D insufficiency.
Objectives We aimed to evaluate whether vitamin D deficiency is associated with cervical human papilloma virus (HPV) infection in women with SLE.
Methods We conducted a cross-sectional, prospective, observational study in women with SLE (1997 ACR classification criteria). A structured questionnaire was administered to the study subjects to ascertain the possible behavioural and biologic risk factors associated with cervical HPV infection. The Systemic Lupus Erythematosus Disease Activity Index, validated for the Mexican population (mexSLEDAI) was used to assess disease activity. A gynaecological evaluation and cervical cytology screen were performed. HPV detection and genotyping were made by PCR and linear array assay. Plasma 25(OH) levels were quantified by enzyme immunoassay.
Results A total of 67 SLE women were analysed. Mean age was 44.8±10.6 years and disease duration 42.5±11.8 years. Median serum vitamin D level was 18.9 ng/mL (p25: 15.2; p75: 23.1). The demographics were similar in patients with and without vitamin D insufficiency (<20 ng//mL and ≥20 mg/mL). Nineteen (28.4%) women had cervical HPV infection, of whom 13 (68.4%) had HR HPV infections, and 7 (36.8%) had 2 o more HPV infections. The most prevalent HR HVP types were 59 (42.1%) and 18 (15.7). SLE patients with vitamin D levels <20 ng/mL had a higher prevalence of cervical HPV infection compared to those with vitamin D levels ≥20 ng/mL (30.7% vs. 25.8%; p=0.72). We found no significant difference in vitamin D insufficiency according to HR-HPV infection prevalence (36.8% vs. 31.5%; p=0.73).
Conclusions Women with SLE have a high prevalence of vitamin D deficiency and cervical HPV infection. However, we found no relationship between vitamin D deficiency and cervical HPV. Further multicentre studies with a larger sample size are required to validate our data.
Van Belle TL, Gysemans C, Mathieu C. Vitamin D in autoimmune, infectious and allergic diseases: a vital player? Best Pract Res Clin Metab 2011;25:617-632.
Field CJ, Johnson IR, Schley PD. Nutrients and their role in host resistence to infection. J Leukocyte Biol 2002;71:16-32.
Amital H, Szekanecz Z, Szucs G, Danko K, Nagy E, Csepany T, et al. Serum concentrations of 25-OH vitamin D in patients with systemic lupus erythematosus (SLE) are inversely related to disease activity: is it time to routinely supplement patients with SLE with vitamin D? Ann Rheum Dis 2010;69:1155-1157.
Acknowledgements We would like to thank David Buss for his valuable guidance and advice during this project.
Disclosure of Interest None declared