The value of antiviral immunomodulatory therapy in improving the outcomes of treatment for HPV-associated diseases of the cervix uteri


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Abstract

Objective. To investigate the clinical efficacy of the antiviral immunomodulatory drug Neovir in the combination treatment of patients with human papillomavirus (HPV)-associated cervical intraepithelial neoplasia grades II-III. Subjects and methods. Sixty patients aged 18 to 45 years with histologically verified HPV-associated cervical intraepithelial neoplasia grades II-III were examined and treated. Group 1 patients (n = 30) received the antiviral immunomodulatory drug Neovir at a dose of 250 mg intravenously once daily for 10 days. Group 2 women (n = 30) had traditional therapy: destructive treatment and electroconization. The evaluation of therapeutic efficiency was investigation of the pre- and posttreatment values of local immune parameters (sIgA, IFNa, IFN-γ, IL-1ß, IL-10, and TNF-α measured by Vector-Best test systems (Novosibirsk)), HPV elimination after 3-month therapy, and a reduced recurrence of a dysplastic process. Results. Local immune changes were characterized by a significant decrease in all the examined cytokine profile parameters. The neovir-treated patients were observed to have a 1.7-2.54-fold increase in the levels of the examined cytokines. Control examination demonstrated that every four patients had a normal colposcopic pattern requiring no destructive treatment. The postdestruction epithelization period was uncomplicated in Group 1 patients; complete epithelization was observed 3 weeks after therapy. In Group 2, epithelization was complicated by an additional inflammatory process in 5 patients and by bleeding in 2. A recurrence was found in 4 patients from Group 2 within 3 months. At 6 months after combination therapy, HPV was eliminated in 20 (66.7%) and 13 (43.3%) patients in Groups 1 and 2, respectively (U = 5.464; p = 0.004). Conclusion. It is appropriate to perform combination therapy including the use of the antiviral immunomodulatory drug Neovir before destructive treatment options to activate local immunity and interferonogenic parameters and to enhance the efficiency of treatment for cervical intraepithelial neoplasias associated with HPV infection.

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About the authors

Irina N. Kononova

Ural State Medical University, Ministry of Health of Russia

Email: irkon@e1.ru
PhD, associate professor in the Department of obstetrics and gynecology

Tatyana A. Oboskalova

Ural State Medical University, Ministry of Health of Russia

Email: oboskalova.tat@yandex.ru
PhD, MD, head of the Department of obstetrics and gynecology

Oksana A. Gizinger

Research Institute of Immunology, South Ural State Medical University, Ministry of Health of Russia

Email: ogizinger@gmail.com
PhD, MD, Professor of the Department of microbiology, virology, immunology and clinical laboratory diagnostics, senior researcher

Ekaterina S. Voroshilina

Ural State Medical University, Ministry of Health of Russia

Email: voroshilina@gmail.com
PhD, MD, associate Professor in the Department of microbiology, virology, immunology

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