ROLE OF GENOTYPING FEATURES IN THE DEVELOPMENT OF RECURRENT VULVOVAGINAL CANDIDIASIS AND THERAPY TACTICS

Abstract

Relevance: According to the literature, Vulvovaginal candidiasis (VVC) is diagnosed in 75% of women during life, and in 5-8% of women its recurrent course is developed (four or more episodes of exacerbation during 12 months). Recurrent vulvovaginal candidiasis (RVVC) is often observed in the presence of development risk factors, but often the recurrent course of the disease is developing among women without obvious risk factors. The literature shows that the development of a recurrent fungal infection is often caused by a violation of the local immune response, which is associated with the polymorphism of the immune system genes. Objective of the study : To develop criteria for forecasting the recurrent current volvovaginal candidiasis to improve the effectiveness of therapy. Study results : As a result of our study, it has been found that C. albicans remains the leading fungal species in the acute and recurrent VVC, but women with the recurrent course of VVC the prevalance of non-C. Albicans fungi is reliably higher than the patients with acute VVC (P = 0.037). Also, the sensitivity data obtained shows that most of the studied yeast fungi (97.5%) are sensitive to fluconazole. However, only in 10.5% of the non-C.Albicans strains resistance was detected. The determination of genetic predisposition to develop the recurrent current VVC, using the prediction model derived from our study, revealed that 77.8% of women with a genetic predisposition are developing a relapse of VVC. In view of these results and based on international recommendations (CDC, WHO, 2011) that it is appropriate to indicate the anti-recurring antifungal treatment to RVVC, it can be concluded that for patients with genetic predisposition to the development of recurrent VVC it is advisable to indicate the anti-recurrent antifungal therapy.