PO:17:248 | Prevention of human papillomavirus infection in women with systemic lupus erythematosus: a single-center cross-sectional study

Clizia Gagliardi¹, Maria Chiara Gerardi¹, Bianca Lucia Palermo¹, Giulia Carrea¹, Maria Di Cicco¹, Elena Manna¹, Giulia Segatto¹, Antonella Adinolfi¹, Laura Belloli¹, Cinzia Casu¹, Silvia Cavalli¹, Davide Antonio Filippini¹, Matteo Longhi¹, Gabriella Maioli¹, Martina Schettino¹, Nicola Ughi¹, Elisa Verduci¹, Arianna Bertolucci¹, Lara Buffa¹, Giulia Buonsante¹, Claudia Cordini¹, Eleonora Giacobbe¹, Francesco Molica Colella¹, Oscar Epis¹ | ¹ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy

Background. Women with systemic lupus erythematosus (SLE), especially those treated with immunosuppressants, have a greater risk of developing cervical cancer related to the human papilloma virus (HPV). Vaccination against HPV and screening for early detection of HPV are safe and effective prevention measures. The objectives of this study are to evaluate vaccine coverage and adherence to the HPV infection screening programs in women with LES, as well as investigate the incidence of infection in these patients.

Methods. A cross-sectional study was conducted by administering an anonymous survey on vaccination and infection screening adherence to consecutive SLE patients attending our center's Lupus Clinic. Data on HPV infection and HPV vaccination in women were analyzed.

Results. From March to June 2025, 45 women with SLE completed the survey (Table 1). Among these patients, 67% (30/45) expressed uncertainty regarding the safety of vaccines for patients with SLE, while 60% (27/45) reported not knowing which vaccinations are recommended. Regarding HPV vaccination coverage, only 3/45 (6.7%) reported having been vaccinated against HPV, while the majority (33/45, 73.3%) reported not having been vaccinated: 58% (19/33) of unvaccinated patients were in treatment with glucocorticoids (GCs), 82% (27/33) with conventional disease-modifying antirheumatic drugs (cDMARDs), and 27% (9/33) with biological disease-modifying antirheumatic drugs (bDMARDs). Figure 1 describes the reasons that led patients not to undergo vaccination. The main barriers were the lack of recommendation by the doctor (19/33, 56.7%) and lack of information about the vaccine (9/33, 27.3%). 27/45 patients (60%) reported regularly undergoing PAP tests or HPV DNA tests, while 12 (26.7%) declared they did not. Finally, 5/45 patients (11.1%) reported having been diagnosed with HPV infection.

Conclusions. In our study, HPV vaccination coverage was suboptimal in patients with SLE, and the lack of promotion and information about the vaccine was the main barrier. Adherence to screening for early HPV diagnosis was also suboptimal. This underscores the importance of the referring specialist's role in providing information and promoting adherence, in order to improve the level of prevention in these patients.