201 Alemtuzumab related HPV infection and cervical dysplasia: real world data

Background Alemtuzumab a disease-modifying-therapy for relapsing-remitting Multiple Sclerosis (RRMS) increases the risk of Human Papilloma Virus (HPV) and cervical dysplasia. Annual HPV-screening is recommended in the Summary of Product Characteristics. 2018 Public of Health cervical screening programme in the United Kingdom recommends no more than three-yearly screening. Objective To assess HPV infection rate and cervical dysplasias in RRMS-Alemtuzumab-treated patients at Brighton and Sussex University Hospital. Method Review of the cervical screening of Alemtuzumab-treated RRMS female-patients who had received at least one treatment course from March 2015 until January 2019. Results The mean age of 80 female-patients who received Alemtuzumab was 39.1 years. Pre-treatment, 4/80 (5%) patients had a degree of dyskaryosis; 1/80 (1.25%) was HPV-positive. At one-year 5/72 (6.9%) patients who completed and had normal pre-treatment screening had abnormal cervical screening with 1/72 (1.39%) being HPV-positive. No extra HPV-positive cases were seen in year 2 (21-patients) and 3 (7-patients). Conclusion In Alemtuzumab-treated RRMS-patients, rate of HPV infections and cervical dyspasias are comparable to epidemiological studies. Whereas it is important that women engage with the national cervical screening, more frequent screening may not be justified. Additional testing might not be of any benefit and might be a source of anxiety for the patients.