HMN 2026: How Thyroid eye disease is tied to higher prevalence of human papillomavirus

Patients with thyroid eye disease (TED) have a higher prevalence of low-risk human papillomavirus (HPV) diagnosed before autoimmune hyperthyroidism onset than matched controls, according to a research letter published online Feb. 12 in JAMA Ophthalmology.

Moshe I. Weber, from the Albert Einstein College of Medicine in Bronx, New York, and colleagues examined the association between HPV and TED using data from deidentified electronic health records from the TriNetX Live Research Network (26,823 matched cases with autoimmune hyperthyroidism and TED).

The researchers found that the prevalence of low-risk HPV was greater in patients with TED than in matched controls (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.16 to 2.03; P = 0.003). There was no difference seen in new-onset HPV infections following an autoimmune hyperthyroidism diagnosis between patients with TED (38 patients) and matched controls (31 individuals; OR, 1.23; 95% CI, 0.76 to 1.97; P = 0.40). The incidence of low-risk HPV before autoimmune hyperthyroidism was greater than after autoimmune hyperthyroidism (205 versus 69; OR, 2.97; 95% CI, 2.26 to 3.90; P

There was no association observed for high-risk HPV and TED status before (OR, 1.02; 95% CI, 0.80 to 1.30; P = 0.85) or after (OR, 0.91; 95% CI, 0.72 to 1.14; P = 0.41) autoimmune hyperthyroidism onset. When comparing 201 patients with TED and low-risk HPV and matched TED controls, patients with low-risk HPV had greater rates of orbital decompression surgery (13.43 versus 5.47%; risk ratio, 2.46; 95% CI, 1.25 to 4.81; P = 0.006) versus those without HPV. The groups were similar with respect to rates of corticosteroid use, vision loss, eyelid retraction, and strabismus.

“These results suggest that molecular mimicry of HPV is a factor in the pathogenesis of TED,” the authors write.

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