Prevalence of anogenital infection by Human Papillomavirus (HPV) in users of immunobiological therapy




Monoclonal Antibodies; Condyloma Acuminate; Inflammation; Sexually Transmitted Viral Diseases; Immunosuppressants.


Objective: To compare the prevalence of anogenital infection by human papillomavirus (HPV) in immunobiological users being treated for immune-mediated chronic inflammatory diseases with that in non-users. Methodology: The total sample studied consisted of 228 participants divided into 2 groups: 114 users and 114 non-users of immunobiological, cytotoxic or corticosteroid therapy, with non-psoriasis dermatoses and non-HPV predisposing conditions. Both groups were evaluated clinically and by polymerase chain reaction (PCR). Results: The prevalence of low-risk HPV in the immunobiological user and non-user groups was 8/49 (16,3%) and 3/29 (10,3%), respectively (p=0.524). The low-risk types found were HPV 6, 11, 40, 42 and 44. The prevalence of high-risk HPV was 23/114 (20,2%) in the users versus 21/114 (18,4%) in the non-users (p=0.737), distributed according to the following types: HPV 16 (3/228 – 1,3%), 18 (5/228 – 2,2%), and non-16/18 (36/228 – 15,8%). After pairing by sex and age, the prevalence of high-risk HPV was 13/62 (21,0%) and 8/62 (12,9%) for immunobiological users and non-users, respectively (p=0.231). Conclusion: The prevalence of anogenital HPV infection in patients with immune-mediated chronic inflammatory diseases treated with immunobiologicals is similar to that in non-users.


Anderson, M. E., Queen, D., Vance, S. L. & Geskin, L. J. (2018). Ustekinumab-associated disseminated verrucae. JAAD Case Reports, 4 (10), 1030-1033.

Antoniou, C., Kosmadaki, M. G., Stratigos, A. J. & Katsambas, A. D. (2008). Genital HPV lesions and molluscum contagiosum occurring in patients receiving anti-TNF-alpha therapy. Dermatology, 216 (4), 364-365.

Bao, Y. P., Li, N., Smith, J. S., Qiao, Y. L. & ACCPAB members. (2008). Human papillomavirus type distribution in women from Asia: a meta-analysis. International Journal of Gynecological Cancer, 18 (1), 71-79.

Bellaud, G., Gheit, T., Pugin, A., Prétet, J. L., Tommasino, M., Mougin, C. & Aubin, F. (2014). Prevalence of human Papillomavirus DNA in eyebrow hairs plucked from patients with psoriasis treated with TNF inhibitors. Journal of the European Academy of Dermatology and Venereology, 28 (12), 1816-1820.

Brunet-Possenti, F., Charpentier, C., Collin, G., Descamps, D. & Descamps, V. (2018). Impact of anti-interleukin-17 treatment on cutaneous and genital human papillomavírus infection. The British Journal of Dermatology, 179 (5), 1179-1180.

Colpani, V., Falcetta, F. S., Bidinotto, A. B., Kops, N. L., Falavigna, M., Hammes, L. S., Benzaken, A. S., Maranhão, A. G. K., Domingues, C. M. A. S. & Wendland, E. M. (2020). Prevalence of human papillomavirus (HPV) in Brazil: A systematic review and meta-analysis. PLoS ONE, 15 (2), e0229154.

Dixon, W. G., Hyrich, K. L., Watson, K. D., Lunt, M., Galloway, J., Ustianowski, A., BSRBR Control Centre Consortium, DPM Symmons & BSR Biologics Register. (2010). Drug-specific risk of tuberculosis in patients with rheumatoid arthritis treated with anti-TNF therapy: results from the British Society of Rheumatology Biologic Register (BSRBR). Annals of the Rheumatic Diseases, 69 (3), 522–528.

Dommasch, E. D., Abuabara, K., Shin, D. B., Nguyen J., Troxel, A. B. & Gelfand, J. M. (2011). The risk of infection and malignancy with tumor necrosis factor antagonists in adults with psoriatic disease: a systematic review and meta-analysis of randomized controlled trials. Journal of the American Academy of Dermatology, 64 (6), 1035-1050.

Fedrizzi, E. N. (2011). Epidemiologia da infecção genital pelo HPV. Revista Brasileira de Patologia do Trato Genital Inferior, 1(1), 3-8.

Forman, D., Martel, C., Lacey, C. J., Soerjomataram, I., Lortet-Tieulent, J., Bruni, L., Vignat, J., Ferlay, J., Bray, F., Plummer, M. & Franceschi, S. (2012). Global burden of human papillomavírus and related diseases. Vaccine, 30 (Suppl 5), F12–F13.

Galloway, J. B., Hyrich, K. L., Mercer, L. K., Dixon, W. G., Fu, B., Ustianowski, A. P., Watson, K. D., Lunt, M., Symmons, D. P. M., BSRBR Control Centre Consortium & British Society for Rheumatology Biologics Register. (2011). Anti-TNF therapy is associated with increased risk of serious infections in patients with rheumatoid arthritis especially in the first 6 months of treatment: updated results from the British Society for Rheumatology Biologics Register with special emphasis on risks in the elderly. Rheumatology, 50 (1), 124-131.

Georgala, S., Katoulis, A. C., Kanelleas, A., Befon, A. & Georgala, C. (2012). Letter: Human papilloma virus and molluscum contagiosum lesions related to infliximab therapy for psoriasis: a case series. Dermatology Online Journal, 18 (4), 9.

Handisurya, A., Lázár, S., Papay, P., Prismas, C., Haitel, A., Horvat, R., Tanew, A., Vogelsang, H. & Kirnbauer, R. (2016). Anogenital human papillomavirus prevalence is unaffected by therapeutic tumour necrosis factor-alpha inhibition. Acta Dermato-Venereologica, 96 (4), 494-498.

Hong, H. S., Akhavan, J., Lee, S. H., Kim, R. H., Kang, M. K., Park, N. H. & Shin, K. H. (2020). Proinflammatory cytokine TNF-α promotes HPV-associated oral carcinogenesis by increasing cancer stemness. International Journal of Oral Science, 12 (1), 3.

Hsien-Yi, C. & Tsen-Fang, T. (2016). The impact of secukinumab treatment on the prevalence of human papillomavirus in patients with psoriasis: a pilot study. Journal of the American Academy of Dermatology, 75 (1), 224-226.

Kane, S., Khatibi, B. & Reddy, D. (2008). Higher incidence of abnormal Pap smears in women with inflammatory bowel disease. The American Journal of Gastroenterology, 103 (3), 631-636.

Kim, S. Y. & Solomom, D. H. (2010). Tumor necrosis fator blockade and the risk of viral infection. Nature Reviews Rheumatology, 6 (3), 165-174.

Koç, E., Tunca, M., Arda, E., Akar, A., Kurumlu, Z. & Demiriz, M. (2008). Multiple widespread warts due to etanercept treatment in a psoriatic patient: a case report. Journal of the Turkish Academy of Dermatology, 2 (1), 82103c.

Lacey, C. J. (2019). HPV vaccination in HIV infection. Papillomavirus Research, 8, 100174.

Marehbian, J., Arrighi, H. M., Hass, S., Tian, H. & Sandborn, W. J. (2009). Adverse events associated with common therapy regimens for moderate-to-severe Crohn's disease. The American Journal of Gastroenterology, 104 (10), 2524-2533.

Mota, L. M. H., Cruz, B. A., Brenol, C. V., Pollak, D. F., Pinheiro, G. R. C., Laurindo, I. M. M., Pereira, I. A., de Carvalho, J. F., Bertolo, M. B., Pinheiro, M. M., Freitas, M. V. C., da Silva, N. A., Louzada-Júnior, P., Sampaio-Barros, P. D., Giorgi, R. D. N., Lima, R. A. C. & Andrade, L. E. C. (2015). Segurança do uso de terapias biológicas para o tratamento de artrite reumatoide e espondiloartrites. Revista Brasileira de Reumatologia, 55 (3), 281-309.

Oliveira, G. R., Vieira, V. C., Barral, M. F. M., Dowich, V., Soares, M. A., Conçalves, C. V. & Martinez, A. M. B. (2013). Risk factors and prevalence of HPV infection in patients from Basic Health Units of an University Hospital in southern Brazil. Revista Brasileira de Ginecologia e Obstetrícia, 35 (5), 226-232.

Parkin, D. M., Bray, F., Ferlay, J. & Pisani, P. (2005). Global cancer statistics, 2002. CA: A Cancer Journal for Clinicians, 55 (2), 74-108.

Sanjosé, S., Brotons, M. & Pavón, M. A. (2018). The natural history of human papillomavirus infection, Best Practice & Research Clinical Obstetrics & Gynaecology, 47, 2-13.

Serrano, B., Brotons, M., Bosch, F. X. & Bruni, L. (2018). Epidemiology and burden of HPV-related disease. Best Practice & Research Clinical Obstetrics & Gynaecology, 47, 14-26.

Singh, H., Demers, A. A., Nugent, Z., Mahmud, S. M., Kliewer, E. V. & Bernstein, C. N. (2009). Risk of cervical abnormalities in women with inflammatory bowel disease: a population-based nested case-control study. Gastroenterology, 136 (2), 451-458.

Singh, J. A., Wells, G. A., Christensen, R., Ghogomu, E. T., Maxwell, L. J., MacDonald, J. K., Filippini, G., Skoetz, N., Francis, D., Lopes, L. C., Guyatt, G. H., Schmitt, J., La Mantia, L., Weberschock, T., Roos, J. F., Siebert, H., Hershan, S., Lunn, M. P., Tugwell, P. & Buchbinder, R. (2011). Adverse effects of biologics: a network meta-analysis and Cochrane overview. Cochrane Database of Systematic Reviews, 2011 (2), CD008794.

Waisberg, M. G., Ribeiro, A. C. M., Candido, W. M., Medeiros, P. B., Matsuzaki, C. N., Beldi, M. C., Tacla, M., Caiaffa-Filho, H. H., Bonfa, E. & Silva, C. A. (2015). Human papillomavirus and chlamydia trachomatis infections in rheumatoid arthritis under anti-TNF therapy: an observational study. Rheumatology International, 35 (3), 459-463.

Yiu, Z. Z. N., Smith, C. H., Ashcroft, D. M., Lunt, M., Walton, S., Murphy, R., Reynolds, N. J., Ormerod, A. D., Griffiths, C. E. M., Warren, R. B. & BADBIR Study Group. (2018). Risk of serious infection in patients with psoriasis receiving biologic therapies: a prospective cohort study from the British Association of Dermatologists Biologic Interventions Register (BADBIR). The Journal of Investigative Dermatology, 138 (3), 534-541.




How to Cite

RONCADA, E. V. M.; CARAPEBA, M. de O. L.; LEVI, J. E. .; ABREU, M. A. M. M. de. Prevalence of anogenital infection by Human Papillomavirus (HPV) in users of immunobiological therapy. Research, Society and Development, [S. l.], v. 11, n. 3, p. e31511326393, 2022. DOI: 10.33448/rsd-v11i3.26393. Disponível em: Acesso em: 9 dec. 2023.



Health Sciences