medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2025-29-62-68medalphabet-4820Research ArticleСтатьиГенотипическое разнообразие, распространенность и эпидемиологическая оценка различных вариантов коинфекции вируса папилломы человека у пациентов дерматовенерологического профиляGenotypic diversity, prevalence and epidemiological assessment of various variants of human papillomavirus coinfection in patients with dermatovenereological profilehttps://orcid.org/0000-0003-0029-7150КасаткинЕ. В.KasatkinE. V.

Касаткин Евгений Владимирович, к. м. н., научный сотрудник, главный врач

Санкт-Петербург

Kasatkin Evgenii V., PhD Med, research fellow, chief physician

Saint Petersburg

kasatkine@gmail.comhttps://orcid.org/0000-0001-9921-3505ЛялинаЛ. В.LyalinaL. V.

Лялина Людмила Владимировна, д. м. н., профессор, заведующая лабораторией эпидемиологии инфекционных и неинфекционных заболеваний, профессор кафедры эпидемиологии, паразитологии и дезинфектологии

Санкт-Петербург

Lyalina Liudmila V., Dr Med Sci (habil.), professor, head of Laboratory of Epidemiology of Infectious and Non-Infectious Diseases, professor at Dept of Epidemiology, Parasitology and Disinfection

Saint Petersburg

ФБУН «Санкт-Петербургский научно-исследовательский институт эпидемиологии и микробиологии им. Пастера» Роспотребнадзора; СПб ГБУЗ «Кожно-венерологический диспансер № 8»РоссияSt. Petersburg Pasteur Institute; Skin and venereological dispensary No. 8Russian FederationФБУН «Санкт-Петербургский научно-исследовательский институт эпидемиологии и микробиологии им. Пастера» Роспотребнадзора; ФГБОУ ВО «Северо-Западный государственный медицинский университет им. И. И. Мечникова» Минздрава РоссииРоссияSt. Petersburg Pasteur Institute; North-Western State Medical University named after I. I. MechnikovRussian Federation202510012026029Эпидемиология, гигиена, инфекционные болезни6268Copyright © Касаткин Е.В., Лялина Л.В., 20262026Касаткин Е.В., Лялина Л.В.Kasatkin E.V., Lyalina L.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/4820Введение

Введение. Вирус папилломы человека (ВПЧ) ежегодно становится причиной более 600000 случаев заболевания и 350000 смертей от рака шейки матки (РШМ). Профилактическая вакцинация против ВПЧ и скрининг являются наиболее действенными методами снижения заболеваемости и смертности от РШМ. В условиях высоких показателей охвата иммунизацией существует вероятность изменения структуры циркулирующих среди населения типов ВПЧ и увеличения риска снижения эффекта от программ вакцинации. Изучение генотипического разнообразия, распространенности коинфекций и взаимодействия генотипов ВПЧ в различных популяциях является комплексной задачей для определения онкогенного потенциала патогена, оценки эффективности вакцинопрофилактики.

Цель исследования

Цель исследования. Изучение генотипического разнообразия, распространенности высокоонкогенных типов вируса папилломы человека и эпидемиологическая оценка вариантов коинфекции у пациентов группы риска по инфекциям, передаваемым половым путем.

Материалы и методы

Материалы и методы. В 2005–2024 гг. обследовано 9056 пациентов, в том числе 1269 женщин, не имеющих жалоб и клинических проявлений заболевания, 751 больной с инфекциями, передаваемым половым путем (ИППП). Проводили обследование на ИППП и определение 12 генотипов ВПЧ. Методы исследования: ПЦР, клинический, эпидемиологический, методы статистики.

Результаты и обсуждение

Результаты и обсуждение. Распространенность ВПЧ среди пациентов дерматовенерологического профиля составила 28,4 %. Наиболее распространенными типами ВПЧ у больных группы риска по ИППП являются как вакцинные (ВПЧ 16), так и невакцинные (ВПЧ 31, 33, 35, 45, 56, 58) генотипы вируса, что важно учитывать при разработке программ скрининга и профилактики. Выявлена распространенность коинфекций ВПЧ и ИППП в 74,7 % случаев, в том числе 74,9 % при микоуреаплазмозах. Множественная ВПЧ-инфекция обнаружена в 15 % случаев, при этом наиболее частые сочетания ВПЧ ВКР включали генотипы 16, 31, 33, 35 и 56. На основе статистического анализа предполагается наличие конкурирующего взаимодействия некоторых пар генотипов ВПЧ.

vaccination and screening are the most effective methods for reducing cervical cancer incidence and mortality. With high immunization coverage, there is a potential for changes in the pattern of HPV types circulating in the population, increasing the risk of reduced effectiveness of vaccination programs. Studying genotypic diversity, the prevalence of coinfections, and the interactions of HPV genotypes in different populations is a complex task for determining the oncogenic potential of the pathogen and assessing the effectiveness of vaccination.

Study objective

Study objective. To study the genotypic diversity and prevalence of highly oncogenic HPV types and to conduct an epidemiological assessment of coinfection patterns in patients at risk for sexually transmitted infections (STIs).

Materials and methods

Materials and methods. From 2005 to 2024, 9,056 patients were examined, including 1,269 women without complaints or clinical manifestations of disease and 751 patients with STIs. They were tested for STIs and identified 12 HPV genotypes. Research methods included PCR, clinical, epidemiological, and statistical methods.

Results and discussion

Results and discussion. The prevalence of HPV among patients with dermatovenereological profile was 28.4 %. The most common HPV types in patients at risk for STIs are both vaccine-relevant (HPV 16) and non-vaccine-relevant (HPV 31, 33, 35, 45, 56, 58) genotypes of the virus, which is important to consider when developing screening and prevention programs. The prevalence of HPV and STI coinfections was revealed in 74.7 % of cases, including 74.9 % in mycoureaplasmosis. Multiple HPV infection was detected in 15 % of cases, while the most frequent combinations of HPV VCR included genotypes 16, 31, 33, 35 and 56. Based on statistical analysis, competitive interactions are suggested between certain pairs of HPV genotypes.

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The authors declare that there are no conflicts of interest present.