Today, HPV infection is one of the most common and important STDs (predominantly sexually transmitted infections), which infects a large part 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 frequency of dysplasia and cervical cancer increases significantly, the peak of which occurs at 45 years of age.
The clinic performs diagnoses of human papillomavirus infection, as well as procedures for the prevention of infection by 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 not recognized, is subclinical or asymptomatic. Genital HPV infection is highly contagious and is acquired during the first sexual contacts; 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:
- disorders of cellular and humoral immunity
- unfavorable socioeconomic situation;
- sexual behavior;
- concomitant sexually transmitted diseases (herpes, chlamydia, trichomoniasis, gonorrhea, syphilis, etc. );
- hypo and avitaminosis;
- young age;
- smoke;
- pregnancy;
- vaginal dysbiosis.
The virus is also sometimes transmitted from mother to child, both in the womb and during childbirth. In addition, pregnancy is a triggering factor for 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 hormone levels.
It is often necessary to deal with a situation in which a patient is diagnosed with high-risk oncogenic human papillomavirus (HPV). As a rule, doctors immediately report that there is a risk of developing cervical cancer. Often, a very aggressive treatment is prescribed immediately, a biopsy is performed, however, in general, it is not clearly explained what actually occurs and what the future prognosis is. So, if you have a high oncogenic risk of human papillomavirus (HPV) detected by PCR, it doesn't mean that you need to panic. There is nothing serious about this finding, it is just an excuse to undergo an appropriate examination.
Cervical screening, with the aim of identifying human papillomavirus infection at risk of cancer and associated cervical lesions, remains a necessary component of health care and every woman should remember the need to "get through".
How often do you screen and when do you start?
It is important to note that the greatest number of cervical lesions, including serious ones, occur at an early reproductive age. Therefore, it is more advisable to start screening for cervical pathology as early as possible after the onset of sexual activity. Cervical cytological screening should be performed from the age of 18 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 essential to have a gynecologist exam with mandatory cervical exam - colposcopy.
- A simple cervical exam 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 can 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 done 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 cervical smear is obtained with a flat brush and the material is "smudged" on the glass. On what:
- the doctor may not collect cells from the entire surface of the cervix;
- when applied to glass, a smear is obtained with an irregularly applied material (somewhere thicker, somewhere thinner), which does not allow the cytologist to examine it completely and correctly evaluate all the cells obtained;
- the glass with the smear applied can "clog", which also affects the quality of the evaluation of the cells obtained.
A PCR smear will, as a result, show whether the human papillomavirus is present or not. It cannot be used to judge the amount of this virus, and that is important.
So, for the moment, the most accurate diagnostic method isliquid cytology method.
The essence of the method is that the material is removed from the cervix with a special brush that, due to its design, allows to capture cells from the entire surface of the cervix and the 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, allows to overcome bacterial "contamination" and makes it possible to transport the collected cells to the laboratory in optimal conditions.
For the doctor and his patients, the advantages of using the liquid are 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 papillomavirus. . .
One more important analysis can be made from the resulting solution with cells - the determination of a specific protein. The determination of this protein allows to clarify the situation in the identification of altered cells of the cervix, which show indirect signs of transformation. The 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 likelihood of malignant transformation is minimal.
All studies can be performed from a flask with liquid cytological material; the patient does not need additional consultations with the doctor, which means that the performance of simultaneous or sequential cytology and genetic detection of the virus and, therefore, the complete screening of cervical lesions, in this case, is facilitated to the maximum.
The use of a liquid material collection method to examine women for cervical infectious pathology is the most logical and economically viable approach. But the most important thing is that this new technology makes it possible to increase the effectiveness of cervical screening and not to "let go" those women whose cervical lesions have already acquired the status of "pre-cancerous".
During the study of the new research technique, a comparative analysis of the traditional technique and liquid cytology was carried out. As a result of analyzing more than 100 traditional cervical smears, "suspicious" or so-called "atypical" cervical cells were found in only every five women and as a result of a new liquid cytological study - every two women.
This triple test allows you to analyze your cervical cells as accurately as possible and decide what to do next.
This 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 human papillomavirus. This test should be performed prophylactically once a year, in which case you can be sure that you will not miss any changes to the cervix.