- Clinical-immunological aspects of the tactics of patients with latent papillomavirus infection of the cervix
Clinical-immunological aspects of the tactics of patients with latent papillomavirus infection of the cervix
HEALTH OF WOMAN. 2020.1(147): 18–25; doi 10.15574/HW.2020.147.18
V.P. Lakatosh1, O.L. Dola2, O.Yu. Kostenko1, I.V. Guzhevskaya1, P.V. Lakatosh1, I.V. Poladiсh1, M.I. Antonyuk1
1Bogomolets National Medical University, Kiev
2Perinatal Center, Kyiv
The role of immunological disorders and vaginal microbiocenosis in the persistent form of papillomavirus infection is considered in the article.
The objective: reduction of the frequency of persistent forms in patients with latent papillomavirus of the cervical infection based on the study of clinical and immunological mechanisms of persistence during the course of latent infection by developing and improving the algorithm of patient management tactics.
Materials and methods. Examination and vaccination of women with a latent form of PVI were performed. After the treatment of concomitant sexually transmitted infections, vaccination was performed according to the scheme.
Results. It is proved that the main etiologic strain of persistent form in the latent course of CMV PVI is HPV of high carcinogenic risk – type 16 and type 18 in most cases with medium (3Lg – 5Lg/105) and high (more than 5Lg/105) levels of viral load, especially when combined with HPV with another sexually transmitted infection (62%). In the transient form, the etiologic strain is HPV of low carcinogenic type 6 and type11 low viral load (<3Lg/105), diagnosed in 100.0% of cases.
Risk group and role of concomitant infection of vaginal microbiocenosis in activation of virus papilloma have been established. The role of the immune system in the pathogenesis of CMV PV persistence has been demonstrated and the feasibility of vaccination in women with persistent forms of latent CMV PVI has been substantiated. It was found that after 6 months normalization of indicators of systemic and local immunity was observed and there was a slight decrease in viral load of cervical tissues in 77.2% of women.
Conclusion. The treatment of women with persistent form of a latent course of CMV PVI contributed to the normalization of many indicators of systemic and local immunity and had a reduction in the viral load of HPV in 77.2% of women 6 months after the start of vaccination.
Key words: persistent latent PVI, clinical anamnestic risk factors, type of PVL and viral load, state of systemic and local immunity, vaccination.
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