Today, HPV infection is one of the most common and important sexually transmitted infections (especially sexually transmitted infections) that infects a large portion of the sexually active population on 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, culminating at the age of 45 years.
The clinic performs diagnosis of human papillomavirus infection and procedures to prevent infection with sexually transmitted infections following occasional sexual contact.
At least 50% of the sexually active adult population is infected with one or more types of HPV, and in most cases, the genital HPV infection in them is unrecognized, subclinical, or asymptomatic. Genital HPV infection is highly contagious and can be acquired during the first few sexual intercourse; single sexual contact occurs in about 60% of cases.
Risk factors for human papillomavirus infection
Recent studies have found that HPV is a necessary but not a sufficient factor in cervical neoplasia. Risk cofactors for the development of the disease may include:
- 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;
- smoking;
- pregnancy;
- vaginal dysbiosis.
The virus sometimes spreads from mother to child both in the womb and during childbirth. In addition, pregnancy is a provocative factor in the manifestation and growth of neoplasms and their transition to cancer. This is due to a decrease in immune protection and changes in hormonal levels.
We often have to deal with a situation where a patient is diagnosed with a high risk of oncogenic human papillomavirus (HPV). As a general rule, doctors immediately report a risk of developing cervical cancer. Often, quite aggressive treatment is prescribed immediately, a biopsy is performed, but there is usually no clear explanation of what is actually happening and what the future prognosis is. So, if there is a high risk of oncogenic human papillomavirus (HPV) detected by PCR, that doesn’t mean you should panic at all. There is nothing serious about this finding, it is just an excuse for proper investigation.
Cervical screening, which aims to identify human papillomavirus infection that threatens cancer and related cervical lesions, remains a necessary element of health care and all women need to remember the need to "pass it on".
How often should you be screened and when should you 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 screening for cervical pathology as soon as possible after the onset of sexual activity. Cytological screening of the cervix should be performed from the age of 18 or the age of sexual debut. Only this approach will reduce the number of women who are diagnosed late with the disease.
What should be done to prevent the development of cervical cancer?
- Once a year, it is imperative that a gynecologist perform an examination with a mandatory examination of the cervix - colposcopy.
- A simple examination of the cervix is not enough - some tests need to be done. That is, to answer two questions: do they have human papillomavirus, and are there changes in the cells of the cervix that could potentially lead to the development of cervical cancer.
Most commonly, standard clinics and laboratories use a simple cytological smear and a PCR smear to determine the virus (i. e. , with an analysis that simply answers the question of whether it is a virus or not). These analyzes have a number of drawbacks that can significantly affect their accuracy.
Disadvantages of traditional cytology and PCR smear:
With a smooth brush, a smear is taken from the cervix and the substance is "smeared" on the glass. Where:
- the doctor cannot pick up the cells from the entire surface of the cervix;
- smearing on glass with an unevenly applied material (sometimes thicker, sometimes thinner) gives a smear that does not allow the cytologist to fully examine it and correctly evaluate all the cells obtained;
- the glass containing the smear used may become "clogged, " which also affects the quality of evaluation of the resulting cells.
The PCR smear as a result shows whether or not the human papillomavirus is present. It can’t be used to judge the amount of virus, and that 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 with a special brush, the design of which allows the cells to be captured from the entire surface of the cervix and from the cervical canal. The brush is then immersed in a special container with the solution. This solution "preserves" the cell material collected by the physician, prevents cell damage, allows bacterial "contamination" to be overcome, and allows the collected cells to be transported to the laboratory under optimal conditions.
The benefits to the physician and his or her patients of using the fluid are resistance to thermal fluctuations, the ability to store cell material for several years, and additional or necessary testing for the full range of genital infections, including genetic testing for human papillomavirus. . .
With the resulting solution, another important analysis can be performed with cells - the determination of a specific protein. The determination of this protein allows the situation to be clarified by identifying altered cells in the cervix that show indirect signs of transformation. Detection of this protein indicates that the cell is severely damaged and is highly likely to malignantly. The absence of this protein indicates that cell failure is not dangerous and the likelihood of malignant transformation is minimal.
All assays can be performed from a vial with liquid cytological material; the patient does not need additional medical visits, which means that the simultaneous or sequential cytology and genetic detection of the virus, and therefore the complete screening of cervical lesions, is maximally facilitated in this case.
The logical and economically feasible approach is to apply a liquid collection method to study the infectious pathology of the cervix in women. But most importantly, this new technology makes it possible to increase the effectiveness of cervical screening and does not exclude women whose lesions on the cervix have already gained "cancer-preventing" status.
In studying the new research technique, a comparative analysis of traditional technique and liquid cytology was performed. As a result of the analysis of more than 100 conventional cervical smears, only one in five women was found to have "suspicious" or so-called "atypical" cervical cells, and as a result of a new liquid cytological examination - in every second woman.
Such a triple test allows you to analyze cervical cells with the greatest possible accuracy and decide what to do next.
Such a test is not only important for women whose cervix has already been altered or who has been diagnosed with oncogenic types of human papillomavirus. This test should be done prophylactically once a year, in which case you can be sure not to miss out on possible changes in the cervix.