Today, HPV infection is one of the most common and important STIs (infections that are mainly sexually transmitted), 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 frequency of dysplasia and cervical cancer increases significantly, the peak of which occurs at 45 years.
The clinic performs diagnosis of human papillomavirus infection, as well as procedures to prevent 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 in them is unknown, subclinical, or asymptomatic. Genital HPV infection is highly contagious and is acquired during first sexual contact; infection with a single sexual contact occurs in about 60% of cases.
Risk factors for human papillomavirus infection
Recent studies have proven that HPV is a necessary but insufficient factor in cervical neoplasia. Co-risk factors for developing the disease may be:
- disorders of cellular and humoral immunity
- unfavorable socio-economic status;
- sexual behavior;
- 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 the womb and during birth. In addition, pregnancy is a provocative factor for the manifestation and growth of neoplasms, as well as their passage into cancer. This is due to a decrease in immune defense and changes in hormonal levels.
Often, one has to deal with a situation when a patient is diagnosed with high oncogenic human papillomavirus (HPV). As a rule, doctors immediately report that there is a risk of developing cervical cancer. Often, a fairly aggressive treatment is prescribed immediately, a biopsy is performed, however, in general, it is not clearly explained what is actually happening and what the next prognosis is. So if you have a high oncogenic risk of human papilloma virus (HPV) detected by PCR, it does not mean at all that you should panic. There is nothing serious about this discovery, it is just an excuse to undergo a proper examination.
Cervical screening, which aims to identify human papillomavirus infection that threatens cancer and the accompanying cervical lesions, continues to be an essential component of health care and every woman should be reminded of the need to "pass" it.
How often does it occur and when should it start?
Importers It is important to note that the largest number of cervical lesions, including severe ones, occur at an early reproductive age. Therefore, it is advisable to start screening for cervical pathology as soon as possible after the start of sexual activity. Cervical cytological examination 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?
- Once a year, it is necessary 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 done. That is, to answer two questions: do you have human papillomavirus and if there are changes in the cells of the cervix that could potentially lead to the development of cervical cancer.
Most often, in ordinary clinics and laboratories, a simple cytological stain and a PCR stain are taken to determine the virus (i. e. an analysis that simply answers the question - does this virus exist or not). These analyzes have some disadvantages that can significantly affect their accuracy.
Disadvantages of conventional cytology and PCR smears:
A stain from the cervix is taken with a flat brush and the material is "smeared" on the glass. Where:
- the doctor cannot take cells from the entire surface of the cervix;
- when applied to glass, a stain is obtained with an unevenly applied material (somewhere thicker, somewhere thinner), which does not allow a cytologist to thoroughly examine it and accurately evaluate all the cells obtained;
- glasses with the applied stain can be "blocked", which also affects the evaluation quality of the cells obtained.
A PCR stain will show as a result whether the human papilloma virus is present or not. It cannot be used to judge the amount of this 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 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 dipped into a separate container with a solution. This solution "preserves" the cellular material collected by the doctor, prevents cell damage, allows it to overcome bacterial "contamination" and makes it possible to transport the collected cells in the laboratory in optimal conditions.
For both the physician and his patients, the advantages of using the fluid 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 infections, including genetic testing for the human papilloma virus. . .
A more important analysis can be done by the resulting solution with the cells - the determination of a specific protein. Determination of this protein makes it possible to clarify the situation when altered cervical cells are identified, which 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. Lack 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 require additional visits to the doctor, which means that the application of simultaneous or consecutive cytology and genetic detection of the virus, and, therefore, the full examination of cervical lesions in this case is maximally facilitated.
Using a liquid method of collecting material for examining women for infectious cervical pathology is the most logical and economically feasible way. But the most important thing is that this new technology makes it possible to increase the effectiveness of cervical screening and not to "lose" those women whose lesions on the cervix have already gained the status of "precancerous".
During the study of 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 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 cytological study ofliquid - 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 important not only for women who have already had changes in the cervix or have been diagnosed with the presence of oncogenic types of papillomavirus. This test should be performed prophylactically once a year, in which case you can be sure that you will not miss any possible changes in the cervix.