OPPORTUNISTIC GENITAL INFECTIONS AND PAPILLOMAVIRUS INFECTIONS: NEW POSSIBILITIES OF IMMUNOMODULATORY THERAPY

Objective. to def ine the frequency of combined types of human papillomavirus (HPV) and opportunistic vaginal infectons (OVI), to give a clinical estimation, and to study the possibilities of immunomodulatory therapy in these patient categories. Subjects and methods. According to the treatment option, the patients were divided into the following groups: 1) those who received ornidazole 500 mg twice daily for 5 days, fluconazole 150 mg at a 2-day interval, then 150 mg once monthly for 6 months (on the first day of menstruation), topical antiseptics for 10 days (a basis group); 2) those who took the immunomodulator Lavomax in addition to the basic therapy (basis + Lavomax). A comparison group consisted of 50 apparently healthy women. The investigators used real-time polymerase chain reaction, microscopy study of cervical discharges, impression smear cytology, extended colposcopy, biopsy, ultrasonic scanning of small pelvic organs, examination of local immunity (cellular immunity indices and sIgA, IqА, IgM, IgG concentrations). The immunomodulator Lavomax was used in accordance with the manufacturer’s recommendations. Results. The patients with HPV concurrent with OVI were found to have a high percentage of concomitant vaginal candidamycoses and bacterial vaginoses, as well as significant impairments in the cellular and humoral immunity system of the genital tract. The most marked normalization of cellular immunity values and sIgA levels, HPV elimination, and a lower viral load were observed in patients whose treatment used Lavomax. Conclusion. Therapy using the immunomodulator Lavomax is a pathogenetically reasonable treatment for HPV infection concurrent with OVI, which permits its incorporation into combination therapy for complicated forms of HPV infection.

papillomavirus infection, opportunistic vaginal infections, immunomodulatory therapy, lavomax (tilorone)