Infecção pelo HPV em mulheres da zona sul do Rio Grande do Sul e fatores associados ao desenvolvimento de lesões precursoras e câncer da cerviceuterina

Abstract

Cervical cancer is currently the third malignancy on number of female deaths in the world. Studies have shown that persistent HPV infection is the main agent involved in cervical cancer development. Particularly of high risk (HR) HPV types 16 and 18, accountable for approximately 75% of cervical cancer cases. Knowledge on infection persistence and correlation with cervical cancer has increased the demand for HPV detection molecular tests. The most used techniques are PCR and Hybrid Capture 2 (HC2). However, techniques for detection of HPV E6/E7 mRNA and p16INK4a have been developed, which are still being validated. These tests may help distinguish transient from persistent HPV infections. Working on reducing the number of cervical cancer cases, screening strategies have been adjusted to contain the best combination of cytological and molecular tests. The ideal screening strategy would require high sensitivity to minimize false negative results, as well as high specificity, in order to avoid false positives and overreferral. Optimization may be achieved by using by cotesting: a combination of HPV genotyping and either cytology triage with low-grade intraepithelial lesions (LSILs) or with atypical squamous cells of undetermined significance (ASC-US). An important measure to reduce cervical cancer cases in prevention through the use of vaccination. Quadrivalent and bivalent vaccines have been approved and used in different countries. The Brazilian National Health System will, from 2014, offer the quadrivalent HPV vaccine free of cost for the vaccination of girls aged between 10 and 11 years old.