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Infections May Influence Where Autoimmune Disease Develops

Study Suggests HPV May Be Linked to Thyroid Eye Disease

A new case-control study published in JAMA Ophthalmology examined whether prior infection with human papillomavirus (HPV) might be associated with thyroid eye disease (TED), a complication of autoimmune hyperthyroidism.

Using a large electronic health record database of approximately 150 million patients, researchers compared individuals with autoimmune hyperthyroidism who developed TED to matched patients with autoimmune hyperthyroidism alone.

What They Found

  • Low-risk HPV was uncommon overall but slightly more frequent in patients with TED.
    • 0.46% of patients with TED had a prior low-risk HPV diagnosis
    • 0.30% of matched controls had a prior low-risk HPV diagnosis
    • That difference equals about 16 additional cases per 10,000 people.
  • High-risk HPV was not associated with TED. Rates were similar between groups.
  • New HPV infections after hyperthyroidism diagnosis were also similar between those who did and did not develop TED.
  • Among patients who already had TED:
    • 13.43% of those with low-risk HPV underwent orbital decompression surgery
    • 5.47% of those without HPV underwent surgery
    • That equals roughly 8 additional surgeries per 100 patients.
  • There were no differences in steroid use, vision loss, eyelid retraction, or strabismus between groups

The authors suggest that molecular mimicry could potentially play a role in disease development. However, this study does not prove that HPV causes thyroid eye disease. It identifies an association based on medical record data, which can contain inconsistencies and incomplete documentation.

More research is needed to determine whether HPV contributes directly to disease mechanisms or whether the association reflects shared risk factors.

Citation

Weber, M. I., Karanfilian, T., Gupta, L., & Barmettler, A. (2026). Thyroid Eye Disease and the Prevalence of Human Papillomavirus. JAMA ophthalmology, e256244. Advance online publication. https://doi.org/10.1001/jamaophthalmol.2025.6244