Features of HPV infection in women of reproductive age and effective methods for diagnosing HPV-associated cervical pathology

Background. Cervical cancer is a group of diseases with a proven etiological agent, while at the same time it has steadily increasing morbidity and mortality rates. In this regard, the development and implementation of effective cervical screening programs are priority task of modern society. Objective. Identification of the features of the course of human papillomavirus (HPV) infection in women of reproductive age and evaluation of the effectiveness of methods for diagnosing HPV-associated cervical pathology. Methods The study included 200 women aged 18-45 years. After 6 months, 84 patients with a positive HPV test underwent examination including: traditional cytology, liquid cytology, extended colposcopy, HPV testing using self-sampling of vaginal discharge and physician-collected samples of the cervical canal. The elimination of HR-HPV (high carcinogenic risk) was assessed after 6 and 12 months. Statistical analysis was performed using IBM SPSS v. 24. Sensitivity and specificity of methods in the diagnosis of HSIL (Highgrade Squamous Intraepitelial Lesions) were calculated according to generally accepted formulas. Results. After 6 months, HPV DNA was detected in 42.8% (36/84) patients. The elimination of the virus after 6 months occurred in 57.1% (48/84) of women, after 12 months - in 58.3% (21/36), and was more often observed in the age group of 26-35 years. Self-sampling of vaginal discharge for the HPV test showed the greatest sensitivity (70%) and a low specificity rate (57.4%) compared with other methods of diagnosing HSIL. Traditional cytology had low sensitivity (10%) and high specificity (98.1%). Conclusion In women aged 26-35 years, more frequent elimination of HPV-BP was detected. The high prevalence of HSIL according to histology was observed in women under 35 years of age. Self-sampling of vaginal discharge for HPV test was highly sensitive (70%) for diagnosing HSIL and can be used as an alternative primary test in cervical screening programs.

human papillomavirus, HPV test, cervical screening, self-sampling, sensitivity, specificity