Today, HPV infection is one of the most common and important sexually transmitted diseases (infections that are predominantly sexually transmitted) that infect most of the sexually active population on the planet. The peak of HPV infection occurs between ages 18-25 and decreases after 30 years as the incidence of dysplasia and cervical cancer increases significantly, with the peak occurring after 45 years.
The clinic will perform a diagnosis of human papillomavirus infection and procedures to prevent sexually transmitted infection after occasional sexual intercourse.
At least 50% of the sexually active adult population are infected with one or more types of HPV, and in most cases genital HPV infection is undetected, subclinical, or asymptomatic in them. Genital HPV infection is highly contagious and is acquired during initial sexual contact. Infection with a single sexual contact occurs in approximately 60% of cases.
Risk factors for human papillomavirus infection
Recent studies have shown that HPV is a necessary but insufficient factor in cervical neoplasia. Risk factors for developing the disease can include:
- Disorders of cellular and humoral immunity
- unfavorable socio-economic status;
- sexual behavior;
- accompanying 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 uterus and during childbirth. In addition, pregnancy is a provoking factor in the manifestation and growth of neoplasms, as well as their transition to cancer. This is due to a decrease in immune defense and changes in hormone levels.
Very often one has to deal with a situation in which a patient is diagnosed with a high risk of oncogenic human papillomavirus (HPV). Doctors usually report immediately that there is a risk of developing cervical cancer. Often a more aggressive treatment is prescribed immediately, a biopsy is performed, but in general there is no clear explanation of what actually happens and what the future prognosis is. So if you are at high oncogenic risk for the human papillomavirus (HPV) detected by PCR, it doesn't mean you need to panic at all. There is nothing serious about this find, it is just an excuse to undergo an appropriate examination.
Cervical screening, which aims to identify cancer-threatening human papillomavirus infection and associated cervical lesions, remains a necessary part of health care and every woman should remember the need to "pass" it.
How often do you have to screen and when should you start?
It is important to note that the greatest number of cervical lesions, including severe ones, occur at an early reproductive age. Therefore, it is more advisable to start screening for cervical pathology as early as possible after starting sexual activity. Cervical cytological screening should be done from the age of 18 or from the age of sexual debut. It is only thanks to this approach that the number of women who are diagnosed late with the disease will be reduced.
What should be done to prevent cervical cancer from developing?
- Once a year, it is imperative to conduct an examination by a gynecologist with a mandatory examination of cervical colposcopy.
- A simple examination of the cervix is not enough - certain tests need to be done. That is, to answer two questions: do you have human papillomavirus and whether there are changes in the cells of the cervix that could potentially lead to the development of cervical cancer.
In ordinary clinics and laboratories, a simple cytological smear and a PCR smear are usually taken to determine the virus (that is, an analysis that simply answers the question - does this virus exist or not). These analyzes have several drawbacks that can significantly affect their accuracy.
Disadvantages of conventional cytology and the PCR smear:
A swab is taken from the cervix with a flat brush and the material is "smeared" onto the glass. Thereby:
- The doctor must not pick up 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 correctly evaluate all the cells obtained.
- The glass with the smear applied can "clog", which also affects the quality of the assessment of the cells obtained.
As a result, a PCR smear shows whether the human papillomavirus is present or not. It cannot be used to gauge the amount of this virus, and that is important.
Therefore, it is currently the most accurate diagnostic methodMethod of fluid cytology.
The essence of the method is that the material is removed 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 the cervical canal. Next, the brush is immersed in a special container with a solution. This solution "preserves" the cell material collected by the doctor, prevents cell damage, enables bacterial "contamination" to be overcome and enables the collected cells to be transported to the laboratory under optimal conditions.
For both the doctor and his patient, the benefits of using the liquid include resistance to temperature changes, the ability to store cell material for several years, and the ability to perform additional or necessary tests for the full range of genital infections, including genetic testinghuman papillomavirus. . .
Another important analysis can be carried out from the resulting solution with cells - the determination of a particular protein. Determination of this protein makes it possible to clarify the situation in the identification of altered cells of the cervix that have 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 vial of liquid cytological material; The patient does not need any additional visits to the doctor, which means that the implementation of simultaneous or sequential cytology and genetic detection of the virus and thus complete screening of the cervical lesions is made as easy as possible in this case.
The use of a liquid method of collecting material for examining women for infectious pathology of the cervix is the most logical and economical approach. Most importantly, this new technology makes it possible to increase the effectiveness of cervical screening and not to "miss" women whose lesions on the cervix have already been given "precancerous" status.
In the course of studying new research technology, a comparative analysis of traditional technology and fluid cytology was carried out. As a result of the analysis of more than 100 traditional cervical swabs, "suspicious" or so-called "atypical" cervical cells were found in only every fifth woman and as a result of a new liquid cytological study - in every second woman.
Such a triple test will allow you to analyze the cells of the cervix with the greatest possible accuracy and decide what to do next.
Such a test is not only important for women who have already had changes in the cervix or who have been diagnosed with oncogenic types of the human papillomavirus. This test must be carried out prophylactically once a year. In this case, you can be sure that you will not miss any possible changes in the cervix.