HPV (human papilloma virus) of high oncogenic risk

model of human papilloma virus

Today, HPV infection is one of the most common and important sexually transmitted infections (infections that are predominantly sexually transmitted), and which infects most of the sexually active population of the planet. 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 conducts diagnostics of human papilloma virus infection, as well as procedures for the prevention of sexually transmitted infections after accidental sexual 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 not recognized, subclinical or asymptomatic. Genital HPV infection is highly contagious and is acquired during the first few sexual contacts; infection through a single sexual contact occurs in about 60% of cases.

Risk factors for human papilloma virus infection

Recent research has 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;
  • young age;
  • smoking;
  • pregnancy;
  • vaginal dysbiosis.

The virus is also sometimes transmitted from mother to child in the womb and during childbirth. In addition, pregnancy is a provocative factor for the manifestation and growth of neoplasms, as well as their transition to cancer. This is due to a decrease in the immune defense and a change in hormonal levels.

He often has to deal with a situation where a patient is diagnosed with human papilloma virus (HPV) of high oncogenic risk. As a rule, doctors immediately report that there is a risk of developing cervical cancer. Often a rather aggressive treatment is prescribed immediately, a biopsy is performed, however, it is generally not clearly explained what is actually happening and what the future prognosis is. So, if you have a high oncogenic risk of human papilloma virus (HPV) detected by PCR, that doesn’t mean you need to panic at all. There is nothing serious in this discovery, it is just an excuse to undergo an appropriate examination.

Cervical screening, which aims to identify human papillomavirus infection and associated cervical lesions, is still a necessary component of health care and every woman should remember the need to "pass" it.

How often to screen and when to start?

It is important to note that most cervical lesions, including severe ones, occur at an early reproductive age. Therefore, it is desirable to start checking for cervical pathology as soon as possible after the beginning of sexual activity. Cytological examination of the cervix should be performed from the age of 18 or from the age of sexual debut. Only thanks to this approach, the number of women in whom the disease is detected late is reduced.

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

  1. Once a year, it is necessary 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 performed. That is, answer two questions: do you have the human papilloma virus and are there changes in the cells of the cervix that can potentially lead to the development of cervical cancer.

A simple cytological smear and PCR test (that is, an analysis that simply answers the question - whether this virus exists or not) is most often taken in conventional clinics and laboratories to detect the virus. These analyzes have several shortcomings that can significantly affect their accuracy.

Disadvantages of conventional cytology and PCR smears:

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

  • the doctor may not pick up cells from the entire surface of the cervix;
  • when applied to the glass, a smear is obtained with unevenly applied material (somewhere thicker, somewhere thinner), which does not allow the cytologist to fully examine it and properly assess all the cells obtained;
  • the glass with the applied smear can be "clogged, " which also affects the quality of the evaluation of the resulting cells.

As a result of the PCR smear, it will be shown whether the human papilloma virus is present or not. It cannot be used to estimate the amount of this virus, and that is important.

Therefore, it is currently the most accurate diagnostic methodliquid 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. Next, the brush is immersed in a special container with the solution. This solution "preserves" the cellular material collected by the doctor, prevents cell damage, enables the overcoming of bacterial "contamination" and enables the transport of the collected cells to the laboratory in optimal conditions.

The benefits of fluid use for both the doctor and his patients are resistance to temperature fluctuations, the ability to store cellular material for several years, and the ability to perform additional or necessary tests for a range of genital infections, including genetic testing for human papilloma virus. . .

Another important analysis can be made from the obtained solution with cells - determination of a certain protein. Determination of this protein makes it possible to clarify the situation when identifying altered cervical cells that have indirect signs of transformation. The discovery of this protein indicates that the cell is severely damaged and there is a high probability of its malignant transformation. The absence of this protein indicates that the defect in the cells is not dangerous, and the probability of malignant transformation is minimal.

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

The use of a liquid method of collecting material to examine women for infectious pathology of the cervix is the most logical and economically acceptable approach. But the most important thing is that this new technology enables an increase in the efficiency of cervical screening and does not "miss" those women whose lesions on the cervix have already acquired the status of "precancerous".

During the study of 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 only in every fifth woman, and as a result of new liquid cytological research - in every other woman.

Such a triple test allows you to analyze the cells of the cervix with the greatest 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 who have been diagnosed with the presence of an oncogenic type of human papilloma virus. This test must be performed prophylactically once a year, in which case you can be sure that you will not miss possible changes in the cervix.