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ObjectiveThis study aimed to assess the impact of Sjögren disease (SjD) on the quality of sexual life and its determinants using the Qualisex questionnaire.MethodsThe Qualisex questionnaire was administered to participants within the ASSESS cohort, a French national multicentric prospective cohort of individuals with SjD. Patients’ characteristics and psychometric evaluations were also collected.ResultsAmong the 395 patients of the cohort, 92 (23%) completed the questionnaire, with a median age of 56 (44–59) years and a female ratio of 92% (85/92). The median Qualisex score was 3.4 (1.1–5.9).Comparing the first and last quartiles of the Qualisex score, a worst sexual satisfaction was associated with older age (median (IQR) 58 (52–65) vs 52 (41–56) years, p=0.005), higher EULAR Sjögren’s disease Patient Reported Index (ESSPRI) (6.8 (5.7–7.7) vs 4.3 (2.8–5.3), p<0.0001) lower SF-36 mental and physical scores (respectively, 43 (38–46) vs 49 (47–53), p=0.0035 and 31 (29–35) vs 35 (30–37), p=0.035), higher Depression and Anxiety scores (HADS) (respectively, 9 (7–11) vs 2 (1–4), p<0.0001 and 11 (8–14) vs 7 (4–10), p=0.006). Interestingly, EULAR Sjögren’s disease Disease Activity Index (ESSDAI) score did not differ significantly (4 (1–10) vs 2.5 (1.8–4), p=0.35). In a multivariable analysis, the Qualisex score remained strongly associated with a higher HADS depression score and, to a lesser extent, with a higher ESSPRI. The inability to obtain a score was associated with older age.ConclusionIn SjD patients, sexual satisfaction assessed with the Qualisex score, was strongly associated with depression and, to lesser extent, with ESSPRI, but not with systemic activity.

T-cell responses ( proliferation, intracellular cytokine synthesis and IFN gamma ELISPOT) against human papillomavirus 16 (HPV16) E2 peptides were tested during 18 months in a longitudinal study in eight women presenting with HPV16-related usual vulvar intraepithelial neoplasia (VIN) and their healthy male partners. In six women, anti-E2 proliferative responses and cytokine production ( single IFN gamma and/or dual IFN gamma/IL2 and/or single IL2) by CD4+ T lymphocytes became detectable after treating and healing of the usual VIN. In the women presenting with persistent lesions despite therapy, no proliferation was observed. Anti-E2 proliferative responses were also observed with dual IFN gamma/IL2 production by CD4+ T-cells in six male partners who did not exhibit any genital HPV-related diseases. Ex vivo IFN gamma ELISPOT showed numerous effector T-cells producing IFN gamma after stimulation by a dominant E2 peptide in all men and women. Since the E2 protein is absent from the viral particles but is required for viral DNA replication, these results suggest a recent infection with replicative HPV16 in male partners. The presence of polyfunctional anti-E2 T-cell responses in the blood of asymptomatic men unambiguously establishes HPV infection even without detectable lesions. These results, despite the small size of the studied group, provide an argument in favor of prophylactic HPV vaccination of young men in order to prevent HPV16 infection and viral transmission from men to women.