Goulenok Tiphaine, Sacré Karim
Département de médecine interne, université Paris Cité, Hospital Bichat-Claude Bernard, AP-HP, Paris, France.
Département de médecine interne, université Paris Cité, Hospital Bichat-Claude Bernard, AP-HP, Paris, France; Inserm UMR1149, CNRS ERL8252, laboratoire d'excellence Inflamex, faculté de médecine site Bichat, centre de recherche sur l'inflammation, Paris, France.
Rev Med Interne. 2025 Mar;46(3):164-173. doi: 10.1016/j.revmed.2024.11.001. Epub 2024 Nov 15.
Human papillomavirus (HPV) infections cause cancer of the cervix, vagina, vulva, anus, penis and upper respiratory tract. The prevention of HPV-induced cancers is a public health issue. Patients with systemic lupus are at increased risk of persistent HPV infection and cervical cancer due to treatment-induced immunosuppression. HPV vaccination and screening for precancerous lesions are two effective means of preventing cervical cancer. Despite the demonstrated safety and efficacy of the HPV vaccine, coverage of HPV vaccination in SLE adults remains low. Screening for cervical cancer is only carried out as recommended in one lupus patient in two. Catch-up HPV vaccination, therapeutic vaccination and vaginal self-sampling are innovative prevention strategies adapted to patients at risk of HPV-induced cancer.
Measures to prevent HPV-induced cancers are insufficiently implemented in patients managed for systemic lupus. Healthcare professionals and patients need to be made aware of the importance of HPV preventing vaccination.
人乳头瘤病毒(HPV)感染可引发宫颈癌、阴道癌、外阴癌、肛门癌、阴茎癌及上呼吸道癌。预防HPV引发的癌症是一个公共卫生问题。系统性红斑狼疮患者因治疗导致免疫抑制,持续感染HPV及患宫颈癌的风险增加。HPV疫苗接种和癌前病变筛查是预防宫颈癌的两种有效手段。尽管HPV疫苗已证明其安全性和有效性,但成年系统性红斑狼疮患者的HPV疫苗接种覆盖率仍然很低。仅有二分之一的狼疮患者按建议进行宫颈癌筛查。补种HPV疫苗、治疗性疫苗接种及阴道自我采样是适用于有HPV引发癌症风险患者的创新性预防策略。
在系统性红斑狼疮患者中,预防HPV引发癌症的措施实施不足。需要让医疗保健专业人员和患者认识到HPV预防性疫苗接种的重要性。