Current concepts of HPV as a multifactorial predictor for squamous intraepithelial lesions of the cervix

Human papillomavirus (HPV)-related cervical diseases are currently one of the urgent global health challenges. Due to its high diagnostic efficiency, HPV testing is one of the cervical cancer screening methods. To date, close attention is paid to the identification of the genotype of HPV. It is generally accepted to classify HPV into high and low carcinogenic genotypes, while it is widely believed in clinical practice that HPV genotypes 16 and 18 have the highest risk for developing and progressing precancerous diseases of the cervix. However, recent observations in many countries have shown that this position needs to be revised, as other HPVgenotypes, such as 31, 33, or 51, occur in more cases than HPV genotype 18, and are more commonly associated with squamous intraepithelial lesions (SIL). Nevertheless, a more detailed study of the factors of HPV infection is a promising direction, since many aspects, such as the determination of a HPV viral load and the geographical distribution of various genotypes, are still little studied. In addition, the international community has not come to a consensus as to the detection of several HPV genotypes in one sample. The results of many recent studies on this issue often lead to diametrically opposite conclusions. The HPV test result has a great influence on the choice of further tactics for the behavior of patients with cervical lesions, as well as the correct interpretation of test results and their subsequent extrapolation to each clinical case are extremely important. Conclusion: Thus, HPV is a multifactorial predictor for cervical lesion; the correct interpretation, and the subsequent extrapolation of HPV test results to each specific clinical case are possible only through a comprehensive assessment of the factors of human papillomavirus infection.

squamous intraepithelial lesions, human papillomavirus, HPV viral load, genotyping, diagnostic test systems