The role of combined oral contraceptives in cervical intraepithelial neoplasia occurrence associated with human papillomavirus infection


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Abstract

Aim: To study the incidence and course of cervical intraepithelial neoplasia (CIN) in women infected with highly oncogenic types of human papillomavirus (HPV) infection, who had indications for taking hormonal contraceptive pills in history. Materials and methods: The study included 163 women aged 19-45 years with high-risk HPV types (16, 18, 31, 33, 35, 51, 52, 56, 58). The physical status of HPV-16 was evaluated in 81 women with mono-infection. All women underwent examination in Treatment and Rehabilitation Center of the Ministry of Health of Russia in the period from 2020 to May, 2021. Results: 84 (51.5%) HPV-positive women who had indications for taking hormonal contraceptive pills in history were included in the main group; 79 (48.5%) HPV-positive women who never took hormonal contraception pills were included in the comparison group. It was found that continuous intake of hormonal pills effects the severity of CIN; respectively, in women who took hormonal contraception pills, severe cervical dysplasia was found most often (Н=18.352, р=0.001). Based on the results of the study of three forms of human papillomavirus infection occurrence: episomal, mixed and integrated, it can be assumed that continuous intake of hormonal contraception pills among women with HPV-16 infection in the form of mono-infection, may have effect on the physical status of HPV and accelerate the progression of human papillomavirus infection to the integrated form (Uemp.=88.5, р=0.001). Conclusion: Thus, it can be assumed that intake of oral hormonal contraceptives may have a negative effect on the course of papillomavirus infection and contribute to development and accelerated progression of CIN. Further studies on this issue will provide development of optimal management tactics for patients taking hormonal contraception pills with purpose of timely diagnosis and reduction of the risk of neoplastic progression and development of invasive forms of cervical cancer.

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About the authors

Lidia A. Klyukina

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

post-graduate student of the Department of Obstetrics and Gynecology No. 1, NV. Sklifosovsky Institute of Clinical Medicine

Elena A. Sosnova

I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: sosnova-elena@inbox.ru
Dr. Med. Sci., Professor of the Department of Obstetrics and Gynecology No. 1, N.V. Sklifosovsky Institute of Clinical Medicine

Anton A. Ischenko

Treatment and Rehabilitation Center of the Ministry of Health of Russia

Email: ra200l_200l@mail.ru
PhD., Senior Research Associate, Head of the Center for Gynecology and New Reproductive Technologies

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