HPV (human papillomavirus) with a high oncogenic risk

model of human papillomavirus

Today, HPV infection is one of the most common and important STIs (sexually transmitted infections) that infects the majority of the world's sexually active population. The peak of HPV infection occurs at the age of 18-25 years and decreases after 30 years, when the incidence of dysplasia and cervical cancer increases significantly, the peak of which occurs at 45 years.

The clinic diagnoses human papillomavirus infection, as well as procedures to prevent sexually transmitted infections after careless intercourse.

At least 50% of the sexually active adult population is infected with one or more types of HPV, and in most cases, genital HPV infection is unrecognized, subclinical, or asymptomatic. Genital HPV infection is highly contagious and is acquired during the first few sexual contacts; single sexual infection occurs in about 60% of cases.

Risk factors for human papillomavirus infection

Recent studies have found that HPV is a necessary but insufficient factor in cervical neoplasia. Risk factors for the development of the disease can be:

  • disorders of cellular and humoral immunity
  • unfavorable socio-economic status;
  • sexual behavior;
  • concomitant sexually transmitted diseases (herpes, chlamydia, trichomoniasis, gonorrhea, syphilis, etc. );
  • hypo- and avitaminosis;
  • early age;
  • smoking;
  • pregnancy;
  • vaginal dysbiosis.

The virus is sometimes transmitted from mother to child both in utero and during birth. In addition, pregnancy is a provoking factor for the manifestation and growth of neoplasms, as well as their transition to cancer. This is due to decreased immune defenses and changes in hormone levels.

Quite often a person has to deal with a situation where the patient is diagnosed with human papillomavirus (HPV) with a high oncogenic risk. As a rule, doctors immediately report that there is a risk of developing cervical cancer. Quite aggressive treatment is often prescribed immediately, a biopsy is performed, but in general it is not clearly explained what is actually happening and what the future prognosis is. So, if you have a high oncogenic risk of human papillomavirus (HPV) detected by PCR, it does not mean that you should panic. There is nothing serious in this finding, it is just an excuse to undergo a proper examination.

Cervical screening, aimed at identifying a cancer-threatening human papillomavirus infection and related cervical lesions, continues to be a necessary component of health care and every woman must remember the need to "pass" it.

How often to check and when to start?

It is important to note that the largest number of cervical lesions, including severe ones, appear in early reproductive age. Therefore, it is more advisable to start screening for cervical pathology as early as possible after the onset of sexual activity. Cytological screening of the cervix should be performed from the age of 18 or from the age of sexual onset. Only thanks to this approach reduces the number of women in whom the disease is detected late.

What should be done to prevent the development of cervical cancer?

  1. Once a year it is mandatory to undergo an examination by a gynecologist with a mandatory examination of the cervix - colposcopy.
  2. A simple examination of the cervix is not enough - certain tests must be done. That is, to answer two questions: do you have human papillomavirus and are there changes in the cells of the cervix that could potentially lead to the development of cervical cancer.

Most often, in ordinary clinics and laboratories, a simple cytological smear and cytosmear are taken by PCR to determine the virus (ie, an analysis that simply answers the question - whether there is this virus or not). These analyzes have several shortcomings that can significantly affect their accuracy.

Disadvantages of conventional cytology and PCR smear:

With a flat brush, a smear is taken from the cervix and the material is "smeared" on the glass. Where:

  • the doctor may not take cells from the entire surface of the cervix;
  • when applied on glass, a smear is obtained with unevenly applied material (somewhere thicker, somewhere thinner), which does not allow the cytologist to examine it completely and correctly to evaluate all the obtained cells;
  • the smeared glass can "clog", which also affects the quality of the evaluation of the resulting cells.

A PCR smear will determine whether or not human papillomavirus is present. It cannot be used to estimate the amount of this virus and it matters.

Therefore, currently the most accurate diagnostic method isliquid cytology method.

The essence of the method is that the material is taken from the cervix using a special brush, which due to its design allows you to capture cells from the entire surface of the cervix and from the cervical canal. Then the brush is immersed in a special container with solution. This solution "stores" the cellular material collected by the doctor, prevents cell damage, allows a person to overcome bacterial "contamination" and makes it possible to transport the collected cells to the laboratory under optimal conditions.

For both the physician and his patients, the benefits of using the fluid are its resistance to temperature fluctuations, the ability to store cellular material for several years, and the ability to perform additional or necessary tests for the full range of genital infections, includinggenetic tests for human papillomavirus. . .

Another important analysis can be made from the resulting cell solution - the determination of a specific protein. The determination of this protein makes it possible to clarify the situation when identifying altered cells of the cervix that have indirect signs of transformation. The discovery of this protein indicates that the cell is severely damaged and has a high probability of malignant transformation. The lack of this protein indicates that the defect in the cells is not dangerous and the likelihood of malignant transformation is minimal.

All tests can be performed from a single vial of liquid cytological material; the patient does not need additional visits to the doctor, which means that the application of simultaneous or sequential cytology and genetic detection of the virus and therefore full screening of cervical lesions in this case is maximally facilitated.

The use of a liquid method to collect material for the examination of women for infectious pathology of the cervix is the most logical and economically feasible approach. But most importantly, this new technology makes it possible to increase the efficiency of cervical screening and not to "miss" those women whose cervical lesions have already acquired the status of "precancerous".

In the course of studying the new research technique, a comparative analysis of the traditional technique and liquid cytology was performed. As a result of the analysis of more than 100 traditional cervical smears, "suspicious" or so-called "atypical" cervical cells were found in only every fifth woman, and as a result of a new liquid cytological examination - in every second woman.

Such a triple test allows you to analyze the cells of the cervix with the highest possible accuracy and decide what to do next.

Such a test is important not only for women who have already had changes in the cervix or have been diagnosed with the presence of an oncogenic type of human papillomavirus. This test should be performed prophylactically once a year, in which case you can be sure that you are not missing possible changes in the cervix.