Цервикальные и анальные неоплазии, ассоциированные с вирусом папилломы человека: оценка программ вакцинопрофилактики

В обзоре рассмотрена роль ВПЧ в развитии предрака и рака аногенитальной области. Представлены современные данные о распространенности цервикальной (CIN) и анальной интраэпителиальной неоплазии (AIN), ВПЧ- инфекции анальной области среди женщин группы риска (CIN, VIN, VaIN). Рассмотрены методы диагностики ВПЧ- ассоциированных заболеваний аногенитальной области. Анализируется литература о важности разработки скрининга АIN у пациенток с CIN, VIN, VaIN. Представлены результаты собственных исследований ВПЧ-инфекции анальной области у пациенток с цервикальными неоплазиями, данные о тропности ВПЧ к эпителию цервикального канала и эпителия анальной области. Доминирующим типом ВПЧ у пациенток с CIN в цервикальном канале и в анусе является ВПЧ 16 типа. ВПЧ-ассоциированные заболевания шейки матки, в частности CIN, создают риск инфицирования и развития ВПЧ-ассоциированных заболеваний анальной области, в т. ч. и AIN. В России в настоящее время доступна четырехвалентная вакцина против ВПЧ. И хотя исходно она была создана и применялась для защиты от поражений шейки матки, вызванных ВПЧ, в настоящее время ее следует рассматривать и в отношении профилактики других видов предрака и рака аногенитальной области, ассоциированных с ВПЧ.

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