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Section 7. Medical science
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14. Soliman M. A., Hamad K., Peels A. Van Straten, A. Van Zundert and J. Schönberger. Coronary artery bypass surgery in patients with impaired left ventricular function. Predictors of hospital outcome. Acta Anaesthesiol Belg - 2007. - 58:37-44.
15. Serota H.1., Deligonul U., Lee W. H., Aguirre F., Kern M. J., Taussig S. A., Vandormael M. G. Predictors of cardiac survival after percutaneous transluminal coronary angioplasty in patients with severe left ventricular dysfunction. Am. J. Cardiol - 1991; - 67:367-372.
16. Farhan A., Blankenship J. C. Coronary artery stenting in patients with severe left ventricular dysfunction. Journal of Invasive Cardiology - 2005. - 17: 651-654.
17. Briguori C., Aranzulla T. C., Airoldi F., Cosgrave J., Tavano D., Michev I., Montorfano M., Carlino M., Castelli A., Sangiorgi M. G., Colombo A. Stent implantation in patients with severe left ventricular systolic dysfunction. Int J Cardiol - 2009. - 135: 376-384.
18. Kunadian V., Pugh A., Zaman A. G., Qiu W. Percutaneous coronary intervention among patients with left ventricular systolic dysfunction: a review and meta-analysis of19 clinical studies. Coron Artery Dis - 2012. - 23: 469-479.
19. Dudek D.1., Rzeszutko t., Turek P., Sorysz D., Dubiel J. S. Clinical predictors of left ventricular function improvement after percutaneous coronary interventions in patients with ejection fraction below 45%. Przegl Lek - 2001. - 58: 751-754.
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DOI: http://dx.doi.org/10.20534/ESR-16-11.12-102-103
Sharipova Iroda Pulatovna, Senior Researcher of Scientific Research Institute of Virology of the Ministry of Health of Uzbekistan Sharapov Saidhon Mahmudhanovich, virologist doctor of Scientific Research Institute of Virology of the Ministry of Health of Uzbekistan Lokteva Lyubov Mikhailovna virologist doctor of Scientific Research Institute of Virology of the Ministry of Health of Uzbekistan Rakhmanova Jamila Amanovna, assistant professor of Tashkent Institute of Postgraduate Medical Education Mustafayev Khayrulla Murtazaevich, scientific consultant of Scientific Research Institute of Virology of the Ministry of Health of Uzbekistan E-mail: evovision@bk.ru
Prevalence human papillomavirus with high-risk among women with precancerous diseases of the cervix uteri
Abstract: The article presents research data 515 women who carried out the molecular biological study of cervical scrapings under the opportunistic screening for human papillomavirus (HPV) in the Institute of Virology of the Ministry of Health of Uzbekistan, aimed gynecologists after a visual inspection, and is suspected of precancerous and background diseases of the cervix. In 100 (19.4%) out of 515 women HPV genetic material has been found with high oncogenic risk that corresponds to the average level of HPV prevalence worldwide.
Thus, HPV testing in a primary marker cervical pathology studies will reduce the volume five-fold to redistribute more attention to the real risk of women with cervical cancer, which in turn will increase the effectiveness of preventive screening. Keywords: Human papillomavirus, oncogenic risk, preventive screening.
Prevalence human papillomavirus with high-risk among women with precancerous diseases of the cervix uteri
Human papillomavirus (HPV) is the most common viral infection of the genital tract. Most sexually active men and women acquire the infection at some point in their lives, and some can be re-infected [1].
The peak period of acquisition of infection for both women and men begins as soon as they become sexually active. HPV is sexually transmitted, but transmission is not obligatory penetrative sex. Flesh genital contact is a well-established mode of transmission.
Many types of HPV do not cause problems. HPV infections usually pass by themselves without any intervention a few months after their purchase, and 90% are for 2 years. A small proportion of infections by certain types of HPV can persist and develop into cancer[2].
Today, cervical cancer is the most common disease associated with HPV. Nearly all cases of cervical cancer may be caused by HPV infection.
Despite the limited data on anogenital cancers other than cervical cancer and, more and more evidence shows HPV due to cancer of the anus, vulva, vagina and penis. Although these types of cancer are less common than cervical cancer and their relationship with HPV making them potentially preventable through the use of the same primary prevention strategies, as well as for cervical cancer [3; 4].
The types of HPV that do not cause cancer (particularly types 6 and 11) can cause genital warts, and respiratory papillomatosis (a disease in which tumors grow in the respiratory tract, leading from the nose and mouth into the lungs) [5]. Although these conditions are very rarely lead to death, they can often lead to disease. Genital warts are common and highly contagious [6].
To date, among the states of cancer markers in the screening organization in the world all of HPV testing in women more often selected and subsequently study for cervical pathology routine colposcopic and cytological methods [7-10]. Uzbekistan has not yet introduced a standardized system of tracking the HPV and precancerous diseases. Women are recorded on the stage of cancer. Early detection of precancerous conditions, would reduce the incidence of terrible diseases and reduce the economic burden of the disease.
Purpose of the study. The study of the incidence, range and load genotypes of human papillomavirus high risk among women with precancerous and underlying diseases of the uterus in order to develop the optimum system for the early screening of cervical cancer.
Material and methods. It was carried out molecular biological study of cervical scrapings of women within the framework of opportunistic screening for HPV in the Institute of Virology of the Ministry of Health of Uzbekistan, aimed gynecologists after
a visual inspection, and is suspected of precancerous and background diseases of the cervix. The study was conducted using a set of reagents for the detection and quantification of DNA of human papillomavirus (HPV) high carcinogenic risk (WRC) 16, 18, 31, 33, 35,39, 45, 51, 52, 56, 58, 59 types of clinical material by polymerase chain reaction (PCR) with hybridization-fluorescence detection "AmpliSens®VPCh WRC-screen-titre the FL" production "InterLabService" Ltd., Russia. The study was conducted in three phylogenetic groups: A7 — types 18, 39, 45, 59; A9-16, 31, 33, 35, 52, 58; A5/A6-51, 56.
Results. A survey of 515 clinical specimens from 100 women (19.4%) revealed the presence of HPV genetic material with a high oncogenic risk. It was found that 43.7% of those infected marked A9 type and follow the type A8/A6 at 36.8%. In less celebrated type A7 19.5%. In 24 cases, exmentioned combination of two or more types: A7 and A9 in 6 (6%), A9 and A5/A6 13 (13%) and A7 and A5/A6 5 (5%) of cases. In 2 cases, it noted the presence of all three groups. The average age of the women ranged from 23 to 48 years old, mean age was 43.9 years (95% CI 24 to 44). (Figure 1) for the phylogenetic group A5/A6 showed a statistically significant (p=0.038) higher age of 40.7 years (95% CI 30.2-51.2). For phylogenetic group A9 has the lowest average age of 31.0 years (95% CI 27,7-34,2). For phylogenetic group A7 average age was 34.1 years (95% CI 28,6-39,6).
In two-thirds of all cases (67%) had an increased concentration of the virus in 25% of cases observed at clinically relevant concentrations, and in 8% of cases, there is no clinically relevant concentrations. For phylogenetic A5/A6 group noted the prevalence of cases with clinically significant levels of virus for the group A7 cases with clinically significant levels and cases with high concentration were observed to the same extent. The phylogenetic group of the A9 noted the prevalence of cases with a high concentration.
The results of our studies show the average level of prevalence of HPV infection due to opportunistic screening, which corresponds to the average level of prevalence worldwide [1]. There is a variety of prevalence of phylogenetic groups and virus concentration. So A5/A6 phylogenetic groups observed at an older age, but in lower concentrations, whereas the group A9 is marked at younger ages and in greater concentration.
Only one-fifth ofwomen, visually defined by practitioners have the HPV virus, which may indicate the low specificity of the supervision of the cervical pathology at the level of primary health care. The use of HPV testing as a primary marker of cervical pathology will reduce the amount of research in five times and redistribute more attention to women with a real risk of cervical cancer, which in turn will increase the effectiveness of preventive screening.
References:
1. Einstein M. H. Clinician's guide to human papillomavirus immunology: knowns and unknowns//Lancet Infect Dis. - 2009. - Vol.9, -No 6. - P. 347-56.
2. Smith J. S. Human papillomavirus type distribution in invasive cervical cancer and high-grade cervical lesions: a meta-analysis up-date//Int J Cancer. - 2007. - Vol. 121, - No 3. - P. 621-32.
3. Pogoda .S., Roden R. B., Garcea R. L. Immunizing against Anogenital Cancer: HPV Vaccines//PLoS Pathog. - 2016. - Vol. 12, - No 5. - P. E 1005-587.
4. Cobos C. The role of human papilloma virus (HPV) infection in non-anogenital cancer and the promise of immunotherapy: a re-view//Int Rev Immunol^ - 2014. - Vol.33, - No 5. - P. 383-401.
5. Entiauspe L. G. Uncommon non-oncogenic HPV genotypes, TP53 and MDM2 genes polymorphisms in HIV-infected women in Southern Brazil//Braz J Infect Dis. - 2014. - Vol. 18. - No 6. - P. 643-50.
