Abstract
Animal studies indicated that human papillomavirus (HPV) transgenic mice develop cataract. Viral infections have been proposed as a potential contributing factor of cataract. This study aimed to examine the association between HPV infection and the risk of developing cataract. We enrolled 224,203 individuals diagnosed with HPV infection between January 1, 2000, and December 31, 2018, from the National Health Insurance Research Database of Taiwan. Propensity-score matching at a 1:1 ratio was conducted to obtain an HPV cohort and a matched non-HPV cohort. We used a Cox proportional hazards regression model to estimate the hazard ratio and 95% confidence interval. The adjusted hazard ratio for developing cataract was 1.36 (95% confidence interval, 1.32-1.39; p < 0.001) in the HPV cohort, and the risk of developing cataract was age-dependent. Females were found to have a higher risk than males. The use of ophthalmic steroids was associated with an elevated risk of cataract formation. Multivariate analysis further highlighted a significant increase in cataract risk within the HPV cohort. Robust sensitivity analyses confirmed that the cumulative risk of cataract was substantially higher in the HPV cohort than in the non-HPV cohort over a 17-year follow-up period (log-rank test, p < 0.001). The use of chlorpromazine was associated with a lower risk of cataract development. However, a significant risk of cataract was observed in HPV patients concurrently treated with chlorpromazine (adjusted hazard ratio, 4.94; 95% confidence interval, 1.82-13.44; p = 0.017). This nationwide cohort study showed that HPV infections are associated with an increased risk of cataract development. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s13337-024-00907-5.