Prevalence, viral load and physical status of human papilloma virus in patients at risk for sexually transmitted infections

Relevance. Human papillomavirus infection (HPV) is the most common sexually transmitted infection (STI) worldwide. High-risk human papillomavirus (HR-HPV) plays a key role in the development of cervical cancer (CC) and other malignant neoplasms (MN) of various localizations. The main tools of modern HPV prevention strategies are vaccination and high-coverage screening of target groups. Patients of dermatovenereological profile belong to high-risk groups for HPV infection and subsequent transmission.

Purpose of the study. To investigate the prevalence of different HPV genotypes and the main biomarkers of malignant neoplasm risk in patients with sexually transmitted infections.

Materials and methods. A total of 32,398 women, patients of healthcare facilities in Saint Petersburg, were examined in 2019–2023. HPV detection, genotyping, viral load determination, and the degree of HPV DNA integration into the human genome were carried out. In the Kaliningrad region, 51,536 women were examined in 2020–2024. Research methods: real-time PCR, clinical, epidemiological, and statistical methods.

Results and discussion. The prevalence of HR-HPV among dermatological-profile patients was 30.5 %–31.3 %, compared to 27.3 % in the gynecological-profile group; the differences were statistically significant (p<0.001). Analysis of viral load in dermatovenereological patients showed the presence of risk for HPV persistence and contact transmission. Among patients with STIs and high viral load, the frequency of HPV integration into the host cell genome was 7–20 times higher than in the non-dermatological profile group, indicating an increased risk of MN development. In the Kaliningrad region, the detection rate of HR-HPV among women aged 30–49 years averaged 9.5 %. However, 42 % of NILM (negative for intraepithelial lesion or malignancy) patients, 88 % of LSIL patients, and 100 % of HSIL patients were HPV-positive; cervical cancer was diagnosed in 71 cases. The most frequently detected HPV types were 16, 31, 33, and 58.

Conclusion. The high prevalence of oncogenic HPV types and the significant risk of malignant neoplasm development among patients with STIs and their contacts justify improving the screening system and including these groups among those recommended for HPV vaccination on epidemiological grounds.

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