HPV Could Be a Contributing Risk Factor for Cardiovascular Disease

South Korean investigators have identified a correlation between infection with high-risk strains of human papillomavirus (HPV) and increased risk of cardiovascular disease (CVD), especially among women with obesity or other cardiovascular risk factors such as metabolic syndrome (MetS).

A total of 63,411 Korean women aged 30 and older without cardiovascular disease at baseline were included in the study and tracked between 2011 and 2016 (median age of 40, median body mass index [BMI] of 22). Approximately 7% of the cohort had high-risk HPV infections, defined as infection with one of 13 strains that can increase the risk for certain cancers, specifically cervical.

After adjusting for BMI and other cardiovascular risk factors, such as smoking status, alcohol consumption, and physical activity levels, investigators determined that women with high-risk HPV were 22% more likely to develop CVD.

“During 261,598.9 person-years of follow-up, 1122 cases of new-onset CVD were identified (incidence rate of 4.3 per 103 person-years). High-risk HPV infection was significantly associated with incident CVD,” investigators wrote in the study published in Circulation Research, an American Heart Association journal. “After adjustment for possible confounders, and high sensitivity C-reactive protein, a significant association between high-risk HPV infection and incident CVD was still observed, with a corresponding HR (95% CI) of 1.25 (1.03-1.52). This association was stronger among individuals with obesity and those with MetS.”

Whether the HPV vaccine can potentially help protect against CVD is something investigators plan to study in the future.

“Better understanding of high-risk HPV as a risk factor for CVD and possible synergistic effect of high-risk HPV, obesity, and metabolic syndrome in increasing CVD risk may help improve preventive strategies and patient outcomes,” Seungho Ryu, MD, PhD, senior co-author of the study and professor at Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, in Seoul, South Korea, told Contagion^® in an interview.

“Before our study, no cohort studies have evaluated the prospective association between high-risk HPV infection and new-onset CVD in general population,” he continued. “Further studies are required to identify the specific high-risk HPV genotypes that may contribute to CVD and to examine whether vaccine strategies to reduce high-risk HPV infection for prevention of ano-genital cancer may also help reduce CVD.”

A number of potential limitations could have affected the outcome of the study, such as the potential of changing HPV status over the course of the study, since infections can sometimes go away on their own.

In October 2018, the US Food and Drug Administration granted expanded use for recombinant HPV vaccine Gardasil 9 to older populations between the ages of 27 and 45.