Lower genital tract infections in young female juvenile idiopathic arthritis patients

Abstract

Background: To evaluate human papillomavirus (HPV), Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infections in juvenile idiopathic arthritis (JIA) patients. Methods: After exclusion, 33 female adolescent and young JIA patients (ILAR criteria) and 28 healthy controls were selected for this study. Demographic data, gynecological, sexual function, cervical cytology and histological abnormalities were evaluated. JIA clinical/laboratorial parameters and treatment were also assessed. HPV-DNA, CT-DNA and NG-DNA testing in cervical specimens were performed by Hybrid Capture 2 assays. Results: The mean current age was similar in JIA patients and controls (23.3 ± 6.24 vs. 26.1 ± 6.03 years, p = 0.09). The frequencies of sexual intercourse (76% vs. 89%, p = 0.201) and abnormal cervical cytology (24% vs. 11%, p = 0.201) were similar in JIA compared to controls. The higher frequency of HPV infection in JIA patients than controls (30% vs. 11%, p = 0.155) did not reach statistical significance. CT (0% vs. 7%, p = 0.207) and NG infections (0% vs. 4%, p = 0.459) were also alike in both groups. Further evaluation of JIA patients with abnormal and normal cervical cytology showed that the former group had a higher frequency of HPV infection (87% vs. 12%, p = 0.0002) with a low frequency of HPV vaccination (0% vs. 8%, p = 1.0). No differences were evidenced between these two JIA groups regarding demographic data, sexual function and clinical/laboratorial parameters. The frequencies of methotrexate (p = 0.206) and biological agent use (p = 0.238) were similar in both JIA groups. Conclusions: To our knowledge, this was the first study to assess lower genital infections in JIA patients allowing the identification of HPV as main cause of cervical dysplasia. Methotrexate and biological agents do not seem to increase risk of lower genital tract infections in JIA patients.

The impact of systemic psoriasis treatments on human papillomavirus activation and propagation

“…A cross‐section study by Ferreira et al on lower genital tract infections in 33 patients with juvenile arthritis on 15–20 mg of methotrexate per week tested cervical specimens for the presence of HPV, Chlamydia trachomatis and Neisseria gonorrhoeae DNA 22 . The frequency of HPV infection was higher in juvenile arthritis patients than in controls, however, without statistical significance (30% vs. 11%, p = 0.155); therefore, the authors assumed that the drug does not seem to increase the risk of HPV infections.…”

The Epidemiological Impact of STIs among General and Vulnerable Populations of the Amazon Region of Brazil: 30 years of Surveillance

“…The discrimination of seroreactivity to C. trachomatis serotypes and discrimination with C. pneumoniae was by microimmunofluorescence [10]. Subsequently, immunoenzymatic assays [11] were made available for the detection of antibodies. In the 2000s, methods of detecting antigens in situ by immunohistochemistry [12] and nucleic acids were used to confirm infection with C. trachomatis [13,14].…”

Human Papilloma Virus Vaccination in Patients with Rheumatic Diseases in France: A Study of Vaccination Coverage and Drivers of Vaccination

“…Some authors measure up to 3.5% of high-grade lesions on smear in a group of 85 lupus patients against 0.5% in healthy controls [ 8 ]. One study found a higher frequency of HPV infection among patients with juvenile idiopathic arthritis (JIA) without significance [ 9 ]. The cause of this interaction is not yet known.…”