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Cervical Stage II Intraepithelial Neoplasia: Antivirals Efficacy

https://doi.org/10.31550/1727-2378-2022-21-1-54-58

Abstract

Study Objective: To assess the efficacy of an antiviral in the management of HPV-associated cervical stage II intraepithelial neoplasia (CIN II), using the analysis of the apoptotic marker levels and cytokine profile — caspase 3 and 9, interferon (INF) γ, interleukin (IL) 18.

Study Design: Perspective study.

Materials and Methods. We examined 126 women of reproductive age. The study included two groups: controls (40 relatively healthy fertile women without any cervical pathologies and HPV) and a group of 86 women with HPV-associated CIN II. All subjects underwent an examination; and their cytokine response and apoptotic marker level were assessed. All patients in CIN II group had the affect area excised. 43 post-excision women were followed up (sub-group A); other 43 subjects had surgery and an antiviral (sub-group B). The antiviral was administered subcutaneously once daily, 3 injections before and 3 injections after the excision. The primary efficacy criteria were absence of HPV or reduction in the viral load below significant values, and absence of pathology relapses after 6 and 12 months of the study.

Study Results. In subjects with CIN II, pre-therapy caspase 3 and 9 levels were significantly higher vs controls; INF-γ was 1.8 times higher than in controls, and mean IL-18 concentration was considerably lower (p < 0.05 in both cases). In sub-groups A and B, caspase 3 and 9 concentration in 3 and 6 months after therapy also differed significantly from controls, and in 6 months, caspase 3 and 9 concentration in sub-group В was considerably lower than in sub-group А. Women in sub-groups А and В demonstrated statistically significant difference in cytokine profile: in both sub-groups, INF-γ concentration in 10 days increased, while in 12 months it almost reached its baseline value. IL-18 in sub-group B in 10 days and 12 months was significantly higher than in sub-group А.

Conclusion. The results of the study demonstrate high HPV elimination and reduction in relapse probability after excision in patients with CIN II with the use of antivirals.

About the Authors

O. P. Vinogradova
Penza Institute of Advanced Physician Training, a branch of the Russian Medical Academy of Continuing Professional Education (a Federal Government-funded Educational Institution of Advanced Professional Education), Russian Federation Ministry of Health
Russian Federation

8A Stasov St., Penza, 440060



N. A. Andreeva
N.P. Ogarev Mordovian National Research State University
Russian Federation

68 Bolshevistskaya Str., Saransk, 430005 



O. I. Artemova
Penza State University (a Federal Government-funded Educational Institution of Higher Education)
Russian Federation

40 Krasnaya St., Penza, 440026



O. V. Epifanova
Penza Institute of Advanced Physician Training, a branch of the Russian Medical Academy of Continuing Professional Education (a Federal Government-funded Educational Institution of Advanced Professional Education), Russian Federation Ministry of Health
Russian Federation

8A Stasov St., Penza, 440060



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For citations:


Vinogradova O.P., Andreeva N.A., Artemova O.I., Epifanova O.V. Cervical Stage II Intraepithelial Neoplasia: Antivirals Efficacy. Title. 2022;21(1):54-58. (In Russ.) https://doi.org/10.31550/1727-2378-2022-21-1-54-58

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ISSN 1727-2378 (Print)
ISSN 2713-2994 (Online)