Today, HPV infection is one of the most common and important STIs (predominantly sexually transmitted infections), infecting most of the sexually active population on the planet. The peak of HPV infection occurs at the age of 18-25 years and decreases after the age of 30, when the frequency of dysplasia and cervical cancer increases significantly, the peak of which occurs at 45 years.
The clinic performs diagnoses of human papillomavirus infection, as well as procedures for the prevention of sexually transmitted infections after casual 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 in them is unrecognized, subclinical, or asymptomatic. Genital HPV infection is highly contagious and is acquired during first sexual contacts; infection with a single sexual contact occurs in approximately 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 socioeconomic situation;
- sexual behavior;
- concomitant sexually transmitted diseases (herpes, chlamydia, trichomoniasis, gonorrhea, syphilis, etc. );
- hiccups and vitamin deficiencies;
- early age;
- of smoking;
- the pregnancy;
- vaginal dysbiosis.
Sometimes the virus is also passed from mother to child both in utero and during childbirth. In addition, pregnancy is a trigger for the development and growth of neoplasms, as well as their transition to cancer. This is due to a decrease in immune defenses and changes in hormone levels.
Very often, one has to deal with a situation where a patient is diagnosed with the high-risk oncogenic human papillomavirus (HPV). As a general rule, doctors immediately report that there is a risk of developing cervical cancer. Often, a fairly aggressive treatment is immediately prescribed, a biopsy is performed, however, in general, it is not clearly explained what really happens and what the future prognosis is. So if you are at high oncogenic risk for human papillomavirus (HPV) detected by PCR, this does not at all mean that you should panic. This finding is not serious at all, it is just an excuse to undergo a proper examination.
Cervical screening, intended to identify cancer-threatening human papillomavirus infection and associated lesions of the cervix, remains a necessary component of medical care and every woman must remember the need to "pass" it.
How often to examine and when to start?
It is important to note that the greatest number of cervical injuries, including serious ones, occur at an early reproductive age. Therefore, it is more advisable to start screening for cervical pathology as soon as possible after the start of sexual activity. Cervical cytological screening should be performed from 18 years of age or from the age of sexual onset. 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?
- Once a year, it is imperative to undergo an examination by a gynecologist 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: do you have the human papillomavirus and are there changes in the cells of the cervix that can potentially lead to the development of cervical cancer?
Most of the time, in ordinary clinics and laboratories, a simple cytological smear and a PCR smear are taken to determine the virus (that is, an analysis that simply answers the question: does this virus exist or not? ). These analyzes have several disadvantages that can significantly affect their accuracy.
Disadvantages of conventional cytology and PCR smear:
A smear is taken from the cervix with a flat brush and the material is "smeared" onto the glass. Where:
- The doctor may not remove cells from the entire surface of the cervix.
- when applied to glass, a smear is obtained with unevenly applied material (somewhere thicker, somewhere thinner), which does not allow a cytologist to fully examine it and correctly evaluate all the cells obtained;
- the glass with the applied smear can "clog", which also affects the quality of the evaluation of the cells obtained.
As a result, a PCR smear will 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 with a special brush, which, due to its design, allows you to capture cells from the entire surface of the cervix and cervical canal. Next, the brush is dipped in a special container with a solution. This solution "preserves" the cellular material collected by the doctor, prevents cell damage, allows overcoming bacterial "contamination" and allows the collected cells to be transported to the laboratory under optimal conditions.
For both the physician and his patients, the advantages of using the liquid 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 infectionsincluding genetic testing. for human papillomavirus. . .
A more important analysis can be performed from the resulting solution with cells: the determination of a specific protein. The determination of this protein makes it possible to clarify the situation when it comes to identifying altered cells of the cervix, which show indirect signs of transformation. Detection of this protein indicates that the cell is seriously 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 performed from a vial with 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 the complete detection of cervical lesions in this case, is facilitated to the maximum.
Using a liquid material collection method to screen women for infectious cervical disease is the most logical and economically feasible approach. But the most important thing is that this new technology makes it possible to increase the effectiveness of cervical screening and not "lose" those women whose lesions on the cervix have already acquired the condition 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 one in five women, and as a result of a new liquid cytology study, in one in two women.
This triple test allows you to analyze the cells of the cervix as accurately as possible and decide what to do next.
Such a test is important not only for women who have already had cervical changes or have been diagnosed with the presence of oncogenic types of human papillomavirus. This test should be done prophylactically once a year, in which case you can be sure that you will not miss possible changes in the cervix.