Интравагинальная пробиотическая терапия как способ управления ВПЧ-инфекцией женских гениталий

Abstract

Objective. To study the possibility of managing human papillomavirus (HPV) infection using intravaginal probiotic therapy. Patients and methods. In the first phase, a retrospective analysis of outpatient medical records of 125 patients for 2 years was caried out to assess the HPV infection outcomes depending on the initial viral load and the state of normal microbial flora. In the second phase (prospective analysis), 43 HPV-positive patients with Lactobacillus deficiency who received (n = 20) or did not receive (n = 23) intravaginal probiotic were selected. The dynamics of HPV viral load were evaluated during the study. The dynamics of Lactobacillus abundance under the influence of probiotic in the groups with different HPV infection outcomes were analyzed. Results. The outcome of HPV infection with HPV viral load of ≤5 lg DNA copies/106 cells depended on the state of normal microbial flora; the value of normal microbial flora with HPV viral load of 5 lg DNA copies/106 cells was not significant. Intravaginal probiotic therapy in combination with antiviral drug in HPV-positive patients with Lactobacillus deficiency was more effective in improving the HPV infection outcomes. A decrease in viral load or HPV elimination was more likely to occur if normal microbial flora was restored as a result of probiotic therapy. Conclusion. Adding intravaginal probiotic therapy with Lactoginal® to antiviral treatment is an effective way to manage HPV infection in the female reproductive tract. Key words: human papillomavirus, vagina, lactobacilli, cervix, epithelial cells