Prevalence and risk factors for high-risk human papillomavirus infection in patients with immune-mediated inflammatory diseases: a prospective study.

Abstract

Objective: Women with immune-mediated inflammatory diseases (IMID) are at increased risk of cervical cancer. We aimed to determine the prevalence of carcinogenic high-risk human papillomavirus (HR-HPV) infection and identify factors associated with infection in women with IMID.

Methods: We conducted a prospective, single-centre study at a French university hospital. We assessed compliance with cervical cancer screening (CCS) recommendations among all patients aged 30-65 years who attended follow-up visits between March 2024 and May 2025. HPV screening with vaginal self-sampling (VSS) was offered to all women not up to date with CCS. The primary outcome was HR-HPV infection prevalence.

Results: Among the 485 patients eligible for CCS, 296 were not up to date with CCS and were therefore eligible for VSS. Of these, 276 (mean age: 48±10 years) consented to participate and were included in the study. HR-HPV was detected in 55 patients (20%, n=55/276), among whom 35% (n=19/55) harboured multiple HR-HPV infections (≥2 types). In multivariable analysis, age at first sexual intercourse (OR (95% CI) 0.85 (0.73 to 0.96)) and number of lifetime sexual partners (OR 1.19 (1.05 to 1.38)) were associated with HR-HPV infection. In exploratory multivariable analyses, longer duration of biological therapy was associated with multiple HR-HPV infections (OR 1.57 (0.99 to 2.85)).

Conclusions: The prevalence of HR-HPV infection in patients with IMID who are not up to date with CCS is 20%. Behavioural factors were associated with HR-HPV infection, while treatment-related findings regarding multiple HR-HPV infections were exploratory and warrant confirmation in larger prospective studies.

Trial registration number: NCT06302725.