Uveitis is the leading cause of preventable blindness in adults aged 20–60 years, and while some details are known about how this develops, new information is emerging that may change the epidemiology of this disease. Uveitis, a condition characterised by inflammation of the middle layer of the eye tissue called the uvea, can be caused by infection, injury, or an inflammatory disease. One such group of infections known to be associated with increased risk of uveitis is the herpes viruses, but little is known about other common viral infections. A new study investigated the association between infection with human papillomavirus (HPV) and subsequent development of uveitis and found evidence to suggest a relationship.
This study, conducted by Hui-Chin Chang and colleagues, leveraged a large electronic health database through the TriNetX US Collaborative Network to include more than 460,000 people with HPV and 460,000 matched controls. Over 15 years of follow-up, these patients were monitored for the development of uveitis. Investigators found that infection with HPV was associated with a 30% higher risk of developing uveitis (hazard ratio 1.30, 95% confidence interval [CI]: 1.19–1.42). In patients who were co-infected with both HPV and herpesvirus, the risk was 2.98 times higher than in controls (95% CI: 1.66–5.35). While more investigation is needed to better understand how specific uveitis presentation matches administrative coding and more detailed HPV strain information, this study highlights a new understanding of uveitis development due to infection. GlobalData epidemiologists monitor uveitis in the US and forecast that diagnosed prevalent cases are expected to increase from 1.11 million in 2026 to 1.18 million in 2033. HPV vaccination, a piece of data not usually presented by GlobalData epidemiologists alongside uveitis, is forecast to be over 70% in 2030 in the US, protecting more than 18 million adolescents from infection.
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This data may have more interplay than previously considered. As vaccination against HPV increases among adolescents in the US, fewer young adults will be susceptible to infection. If, as this study suggests, infection with HPV is associated with increased risk of uveitis, this vaccine may have protective effects wider than previously thought. More study is needed to understand if those strains included in the 9-valent HPV vaccine, a vaccine that protects against specific cancer-causing strains of the virus, are also causative in the development of uveitis. Lower levels of HPV in the general population as vaccinated children become adults may have knock-on effects far wider than the cancers it is designed to prevent, leading to a possible decline in the number of preventable blindnesses caused by uveitis. It remains to be seen if more data can show the added benefit of these already critical vaccines.
