For a study, researchers examined if natural human papillomavirus (HPV) infection would cause an anamnestic reaction to quadrivalent (qHPV) immunization in women with SLE (SLE). Thirty-four women (19-50 years) with mild to moderate SLE that was either minimally active or inactive were given the usual qHPV vaccination. The HPV competitive Luminex Immunoassay was used to assess neutralizing antibody titers to HPV 6, 11, 16, and 18. Logistic regressions were run for each HPV type to investigate the link between a positive titer at baseline and their final geometric mean titer and the growth in the titer. The Fisher’s Exact Test was performed to examine the relationship between at least one positive HPV antibody test at baseline and a history of abnormal pap smears. 

In 52.9% of cases, there was a history of abnormal pap smear/cervical neoplasia. At baseline, anti-HPV antibody titers at baseline: 21% were negative for all four HPV types, whereas 79% were positive for one of the four HPV types. Statistical analysis revealed that those with a history of abnormal pap smears/cervical neoplasia were more likely to have a positive anti-HPV antibody result before vaccination to one of the four kinds, (P = 0.035) Fisher’s Exact Test. In general, HPV-exposed women had greater post-vaccine GMTs and higher point estimates than HPV unexposed women. There was no indication of an anamnestic response when the rise in titers was examined using logistic regression.

Prior HPV infection and cervical neoplasia in SLE had been associated with a lack of anamnestic response to the HPV vaccination. This validated the decision not to screen for HPV antibodies before vaccination.