Today, HPV infection is one of the most common and important STIs (mainly sexually transmitted) that infects the majority of the sexually active population of the planet. The peak of HPV infection occurs between the ages of 18 and 25 and decreases after 30 years, with the peak occurring at age 45 when the incidence of dysplasia and cervical cancer increases significantly.
The clinic diagnoses human papillomavirus infection and performs procedures to prevent sexually transmitted infections after casual sex.
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 intercourse; Single sexual intercourse occurs in about 60% of cases.
Risk factors for human papillomavirus infection
Recent studies have shown that HPV is a necessary but insufficient factor in cervical neoplasia. Risk factors for the development of the disease may be:
- disorders of cellular and humoral immunity
- unfavorable socio-economic situation;
- sexual behavior;
- concomitant sexually transmitted diseases (herpes, chlamydia, trichomoniasis, gonorrhea, syphilis, etc. );
- hypo- and avitaminosis;
- young age;
- to smoke;
- pregnancy;
- vaginal dysbiosis.
The virus is sometimes transmitted to the unborn child, both in infancy and at birth. In addition, pregnancy is a trigger for the appearance and growth of neoplasms, as well as the development of cancer. This is due to a decrease in the level of immune defense and changes in hormone levels.
Often, a situation arises when a patient is diagnosed with human papillomavirus (HPV) with a high oncogenic risk. As a rule, doctors immediately report the risk of developing cervical cancer. Often, an aggressive treatment is prescribed immediately, a biopsy is performed, but in general, it is not clear what will actually happen and what the future prognosis is. So, if you have a high oncogenic risk of human papillomavirus (HPV) detected by PCR, that doesn't mean you should panic. There is nothing serious about this finding, it is just an excuse to undergo a proper examination.
Cervical screening, aimed at identifying human papillomavirus infection and associated lesions of the cervix that threaten cancer, continues to be a necessary component of health care, and every woman should keep in mind that it needs to be "passed. "
How much 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 more appropriate to start the examination for cervical pathology as soon as possible after the onset of sexual activity. Cervical cytology should be performed from the age of 18 or from the age of sexual onset. Only this approach reduces the number of women diagnosed with the disease late.
What can be done to prevent cervical cancer?
- It is important to be examined by a gynecologist once a year with a mandatory examination of the cervix - colposcopy.
- A simple examination of the cervix is not enough - certain tests must be performed. That is, to answer two questions: whether there is human papillomavirus and whether there are changes in the cells of the cervix that could lead to the development of cervical cancer.
Often, in ordinary clinics and laboratories, a simple cytological stain and a stain with PCR are taken to identify the virus (ie, an analysis that simply answers the question - whether it is a virus or not). There are several shortcomings that can significantly affect the accuracy of these analyzes.
Disadvantages of conventional cytology and PCR staining:
A stain is removed from the cervix with a flat brush and the material is "smeared" on the glass. Here:
- the doctor cannot remove cells from the entire surface of the cervix;
- When applied to glass, a stain is obtained from an unevenly applied material (thicker in one place, thinner in another), which does not allow a cytologist to examine it completely and correctly evaluate all the cells obtained;
- The glass can be "clogged" with the applied ointment, which affects the quality of the evaluation of the obtained cells.
As a result, a PCR spot indicates the presence of human papillomavirus. It cannot be used to estimate the amount of virus, and this is important.
For this reason, it is currently the most accurate diagnostic methodliquid cytology method.
The essence of the method is that the material is removed from the cervix using a special brush that allows you to capture cells from the entire surface of the cervix and the cervical canal with a special design. Then, the brush is immersed in a special bowl with a solution. This solution "protects" the cell material collected by the doctor, prevents cell damage, eliminates bacterial "contamination" and allows the collected cells to be transported to the laboratory in optimal conditions.
The advantages of using the fluid for both physicians and patients are resistance to temperature fluctuations, the ability to store cell material for several years, and additional or necessary testing for all genital infections, including genetic testing. for human papillomavirus. . .
Another important analysis from the resulting solution with cells - it is possible to determine a specific protein. Determination of this protein allows to clarify the situation when identifying altered cells of the cervix with signs of indirect transformation. Detection of this protein indicates that the cell is severely damaged and there is a high probability of malignancy. The absence of this protein indicates that the defect in the cells is not dangerous and the likelihood of malignant transformation is minimal.
All studies can be performed from a vial with liquid cytological material; The patient does not need to consult a doctor, which indicates that the simultaneous or sequential cytology and genetic detection of the virus is carried out, and therefore in this case it is easier to fully examine the cervical lesions.
The use of the liquid method to collect material for the examination of women for infectious pathology of the cervix is the most logical and economically expedient approach. But most importantly, this new technology allows to increase the effectiveness of cervical screening and does not "miss" women who have already received "precancerous" status of cervical lesions.
A comparative analysis of traditional techniques and fluid cytology was performed during the study of the new research techniques. Analysis of more than 100 traditional cervical smears found so-called "suspicious" or "atypical" cervical cells in only one in five women, and a new fluid cytological study - in every second woman.
Such a triple test allows you to analyze cervical cells with the highest possible accuracy and decide what to do next.
Such a test is not important only for women who have had a change in the cervix or have been diagnosed with the presence of oncogenic human papillomavirus. This test should be performed prophylactically once a year, in which case you can be sure that you do not miss the possible changes in the cervix.