Today, HPV infection is one of the most common and important STIs (mainly sexually transmitted infections), which infects most of the sexually active population on the planet. The peak of HPV infection occurs at the age of 18-25 and decreases after age 30, when the frequency of dysplasia and cervical cancer increases significantly, peaking at 45years.
The clinic performs human papillomavirus infection diagnoses, as well as procedures for preventing infection with 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 very contagious and is acquired during the first sexual contact; infection with a single sexual contact occurs in about 60% of cases.
Risk factors for human papillomavirus infection
Recent studies have established that HPV is a necessary but insufficient factor in cervical neoplasia. Risk cofactors for the development of the disease can be:
- cellular and humoral immunity disorders
- 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 both in utero and during childbirth. In addition, pregnancy is a factor provoking the manifestation and growth of neoplasms, as well as their transition to cancer. This is due to a decrease in immune defenses and changes in hormonal levels.
Very often one has to face a situation where a patient is diagnosed with high risk oncogenic human papillomavirus (HPV). Usually, doctors immediately report that there is a risk of developing cervical cancer. Often, rather aggressive treatment is prescribed immediately, a biopsy is taken, however, in general, it is not clearly explained what is really going on 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 need to panic at all. There is nothing serious about this finding, it is just an excuse to undergo a proper examination.
Cervical screening, which aims to identify cancer-threatening human papillomavirus infection and associated lesions of the cervix, continues to be a necessary component of healthcare and every womanmust remember the need to "pass" it.
How often to screen and when to start?
It is important to note that the greatest number of cervical injuries, including the most serious, occur at an early childbearing age. Therefore, it is more advisable to start screening for cervical pathology as soon as possible after the onset of sexual activity. Cervical cytological screening should be performed from the age of 18 or from the age of first sexual intercourse. It is only thanks to this approach that the number of women in whom the disease is detected late is reduced.
What should be done to prevent the development of cervical cancer?
- Once a year, it is imperative to undergo an examination by a gynecologist with a mandatory examination of the cervix - colposcopy.
- A simple exam of the cervix is not enough - some tests must be done. That is, to answer two questions: do you have human papillomavirus and if there are any changes in the cells of the cervix that can potentially lead to the development of cervical cancer.
Most often, in ordinary clinics and laboratories, a simple cytological smear and a PCR smear are performed to determine the virus (that is, an analysis that simply answers the question - is there thisvirus or not). These analyzes have several drawbacks which can considerably affect their accuracy.
Disadvantages of conventional cytology and PCR smear:
A smear from the cervix is taken with a flat brush and the material is "smeared" onto the glass. Or:
- the doctor may not collect cells from the entire surface of the cervix;
- when applied to glass, a smear is obtained with an unevenly applied material (somewhere thicker, somewhere thinner), which does not allow a cytologist to fully examine it and properly assessall the cells obtained;
- the glass with the smear applied may "clog", which also affects the quality of the evaluation of the cells obtained.
A PCR smear will thus show whether the human papillomavirus is present or not. It cannot be used to judge the amount of this virus, and that is important.
Therefore, at present, 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. uterus and cervical canal. Then the brush is immersed in a special container with a solution. This solution "preserves" the cellular material collected by the doctor, prevents cell damage, eliminates bacterial "contamination" and allows the cells collected to be transported to the laboratory under optimal conditions.
For the doctor and his patients, the advantages of using the liquid are its resistance to temperature fluctuations, the possibility of storing cellular material for several years and the possibility of performing additional or necessary tests for all genital infections. , including genetic testing. for human papillomavirus. . .
A larger analysis can be made from the resulting solution with cells - the determination of a specific protein. The determination of this protein helps to clarify the situation when identifying the altered cells of the cervix, which show indirect signs of transformation. Detection of this protein indicates that the cell is severely damaged and that 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 likelihood of malignant transformation is minimal.
All studies can be performed from a vial with liquid cytology material; the patient does not require additional visits to the doctor, which means that the simultaneous or sequential implementation of cytology and genetic detection of the virus, and, therefore, the complete screening of cervical lesions in this case is facilitatedto the maximum.
Using a liquid method of collecting material to examine 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" 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 carried out. Following the analysis of more than 100 traditional cervical smears, "suspicious" or so-called "atypical" cervical cells were found in only one in five women and following a new liquid cytology study - in one woman. On two.
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 had changes in the cervix in the past or who have diagnosed the presence of oncogenic types of the human papillomavirus. This test should be done prophylactically once a year, in which case you can be sure not to miss any changes in the cervix.