J Korean Med Sci.  2017 Apr;32(4):599-604. 10.3346/jkms.2017.32.4.599.

Increased Serum Antibody Titer against HPV-16 Antigen in Patients with Behçet's Disease

• Kim KY
• Kim DY
• Seo J
• Ahn Y
• Kim DS

• KMID: 2371444
• DOI: http://doi.org/10.3346/jkms.2017.32.4.599

Abstract

Quadrivalent human papillomavirus (HPV) vaccine has been reported to be significantly associated with Behçet's disease (BD). However, no reports have described HPV infection as a possible cause for the development of BD. The objective of this study was to evaluate whether anti-HPV immunoglobulin G (IgG) antibody titer is increased in BD. Serum samples from 93 Korean BD patients, who fulfilled the diagnostic criteria of the International Study Group for BD, were used in an enzyme-linked immunosorbent assay (ELISA). The clinical activity of BD was evaluated at the time of blood sampling. HPV-16 L1 virus-like particle (VLP) antigen was used in this study for the ELISA. Patients with BD had significantly higher antibody titers against HPV-16 (optical density [OD], 0.210-3.675; mean 0.992) than that of healthy controls (OD, 0.248-0.762; mean 0.517; P < 0.001). Using a receiver operating characteristic (ROC) analysis, a cut-off value of 0.578 OD for the anti-HPV antibody titer was determined that differentiated BD patients from healthy controls. When we compared the clinical features of BD between the 2 groups, articular involvement of BD was more likely in patients with an anti-HPV-16 antibody titer < 0.578 OD (P = 0.035). In addition, patients with an anti-HPV-16 antibody titer < 0.578 were significantly younger than those with a titer ≥ 0.578 OD. HPV itself may be a possible extrinsic triggering infectious agent causing the development of BD.

Keyword

Behçet's Disease; Human Papilloma Virus; Enzyme-Linked Immunosorbent Assay; IgG Antibody

Figure

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  Fig. 1 Serum anti-HPV 16 antibody levels in the patients with BD. (mean OD in BD patients: 0.992; mean OD in normal control: 0.517). HPV = human papillomavirus, BD = Behçet's disease, OD = optical density. * P < 0.001.

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  Fig. 2 Serum anti-HPV 16 antibody levels and determination of cut-off point. Cut-off value for Serum anti-HPV 16 antibody levels which differentiates BD patients from normal controls was determined by Youden index method. Youden index was 0.3954, cut-off point was 0.578 OD. AUC was 0.737. Sensitivity was 67.74%. Specificity was 71.79%. HPV = human papillomavirus, OD = optical density, AUC = area under curve.

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