PAPILLOMAVIRUS INFECTION: FROM EARLY DIAGNOSIS TO RATIONAL THERAPY

Objective. To determine whether it is expedient to use inosine pranobex in human papillomavirus (HPV)-associated diseases with minimal cervical epithelium involvement and HPV infection. Subjects and methods. 302 women aged 18 to 60 years (mean age 35±3 years), including 113 (37.4%) HPV DNA-negative women and 189 (62.6%) HPV DNA-positive ones, were examined. To estimate a viral load, the HPV DNA-positive women were divided into 5 groups: 1) 40(26%) women with latent HPV infection (HPV carriers); 2) 16 (10.3%) with subclinical HPV infection; 3) 34 (22%) with low-grade squamous intraepithelial lesion (LSIL); 4) high-grade squamous intraepithelial lesion (HSIL), and 5) 11 (7.1%) with cancer of the cervix uteri (CCU). Results. The viral load was 3.9 (2.7—5.7) log in Group 1, 4.4 (3.5—6.5) log in Group 2, 5.0 (4.3—6.5) log in Group 3, 5.9 (4.6—6.6) log in Group 4, and 6.7 (6.2—7.8) log in Group 5. It was significantly higher in the CCU group than in the other groups (p<0.01). In the HPV carriers, the viral load was significantly lower than that in LSIL (p=0.021), HSIL (p=0001), and CCU (р=0.00007). A group of patients with cytoplasmic HPV lesion and a positive HPV test (n=34) were given 3 courses of inosine pranobex therapy by the scheme: 2 tablets t.i.d. for 10 days at an 8-day interval with the subsequent determination of HPV and a viral load after 6 months when HPV elimination was noted in 76.4% of cases. Conclusion. The early diagnosis, timely detection, and treatment of HPV-associated diseases promote the prevention of CCU. The use of antiviral agents having an immunomodulatory effect may be warranted in the long-term persistence or reinfection of HPV. Antiviral treatment decreases the likelihood of HPV persistence and recurrent infection.

human papillomavirus, cancer of the cervix uteri, persistence, reinfection, virus carriage, immunomodulators, inosine pranobex