Women infected with human papillomavirus (HPV) are at higher risk for new-onset cardiovascular disease (CVD) and death than their uninfected peers, a Karolinska Institutet–led research team suggests.

For the observational study, published yesterday in PLOS Medicine, the researchers compared the CVD diagnoses of 497,445 HPV-infected women in Swedish national registries with those of roughly 2.5 million uninfected controls. They also compared CVD status among 143,787 infected women and their 174,637 unexposed full siblings.

The authors note that most previous observational research was limited to specific populations and didn’t adequately consider familial factors. HPV infection is well known to cause cervical cancer, but emerging evidence suggests that it may also contribute to CVD.

Sibling comparison yields similar findings

New-onset CVD was identified in 28,793 and 128,373 HPV-infected and uninfected women, respectively, for respective incidences of 8.27 and 7.93 per 1,000 person-years. In total, 1,221 and 4,941 women with and without HPV infection died of CVD, for respective death rates of 33.7 and 29.4 per 100,000 person-years. The risks of CVD and death were greatest within the first year of follow-up, then waned.

The findings suggested that clinicians should be aware of a slightly elevated CVD risk in women with HPV, especially during the first year following an infection.

The risk of new-onset CVD was 7% higher in HPV-infected women than in their uninfected counterparts, for an absolute rate difference of 0.53 cases per 1,000 person-years (population-attributable fraction, 1.16%). 

The risk of death was 25% higher in infected women than in unexposed women, for an absolute rate difference of 6.71 cases per 100,000 person-years (population-attributable fraction, 4.12%).

In the first year of follow-up, the risks of incident CVD and related death were 43% and 86% higher, respectively, in women diagnosed as having HPV. But thereafter, the excess risk fell to 2% for new-onset CVD and 21% for related death.

In the sibling comparison, HPV-infected women had a 5% greater risk of incident CVD and a 25% higher risk of death than their uninfected siblings.

“The findings suggested that clinicians should be aware of a slightly elevated CVD risk in women with HPV, especially during the first year following an infection,” the authors concluded. “However, given the small absolute difference, women should not be unduly concerned.”