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Cervical intraepithelial neoplasia is widespread among patients of the reproductive period, the peak of the incidence occurs at a young age, often when the reproductive function has not yet been performed. The oncological alertness of the medical community is justified: the incidence of cervical cancer has increased by 24.6% over the past ten years, and in the structure of cancer mortality in the age group of 30–39 years cervical cancer occupies the 1st place accounting for 23%. Тhe same time aggressive management of the disease in patients who have not yet performed their reproductive function is associated with the loss of significant volume of cervical tissues and an increase in the frequency of premature birth. The most acute issue is the tactics of managing cervical neoplasia of the second degree of severity, when there is still hope for the regression of the disease, but at the same time there is a high risk of transition to dysplasia of the third degree of severity and subsequently to invasive cancer. The search for diagnostic markers that allow predicting the probability of regression and, conversely, the unfavorable course of the disease is the most important task solution of which will allow optimizing tactics in controversial clinical cases and avoiding unnecessary surgical aggression, improving the perinatal outcomes of patients undergoing surgical treatment. The search for new economically feasible and diagnostically valuable markers allowing us to predict the course of the disease and determine the amount of necessary surgical treatment continues, but the most significant at this moment is still the determination of the coexpression of p16 and Ki-67 in immunocytochemical studies and p16INK4a in immunohistochemical studies. The diagnostic sensitivity of determining the co-expression of p16INK4a/Ki67 is 98.5%, and the expression of p16INK4a in CIN II indicates that in 81% of cases there is a tendency to a progressive course of the disease.

Viral pandemics have shown that infected pregnant women are at risk of adverse pregnancy outcomes. Current evidence suggests that a pregnant woman’s immune system undergoes a transformation necessary to maintain pregnancy and fetal growth. The prevalence of human papillomavirus (PVI) is high, and its role in adverse pregnancy outcomes and reproductive loss is highly controversial. About 90% of cases of persistent human papillomavirus infection (PVI) are eliminated within one to two years. The role of the immune system in the elimination and persistence of PVI has been proven; however, there is no clear understanding of the mechanisms whereby PVI infected cells escape immune surveillance up to the present day. In addition, the immune mechanisms underlying the PVI persistence constitute a pathogenetic basis for the development of mechanisms of infertility, miscarriage and pregnancy pathology. Genetic polymorphism of the mother and the developing fetus, persistent PVI types and microbial landscape are modulating factors with an unexplained contribution in the transformation of quantity of introduced influences into the qualitative change in the biological state. The foreign and Russian research results analysed by the authors show that timely and adequate therapy of PVI may contribute to the preservation of reproductive potential and prevention of obstetric losses. The modern approach to the treatment of persistent PVI suggests the use of antiviral and immunomodulatory therapy. Due to its immunomodulatory and antiviral properties, inosine pranobex is used to treat viral diseases such as PVI, herpes simplex viruses, cytomegalovirus, Epstein-Barr virus and influenza.

Introduction. A genital human papillomavirus infection receives the sword-point attention of both researchers and practitioners, due to its large prevalence in the human population, high contagiousness and, in particular, the ability of some HPV strains to contribute to the development of malignancy. This is particularly so with cervical cancer (CC), one of the most common types of cancer both in the Russian Federation and most countries of the world. It ranked first among the causes of malignant tumour deaths of women aged over 30 years. Objective. To present the experience in using the 3,3’-diindolylmethane-containing drug in the treatment of patients with HPVassociated low-grade cervical intraepithelial lesion. Material and methods. 62 women with HPV-associated low-grade cervical intraepithelial lesion were examined and received treatment with the 3,3’-diindolylmethane-containing drug (Cervicon-DIM). The primary diagnosis and therapeutic outcomes monitoring included the following research methods: colposcopy, histological examination of biopsy cervical specimens, Pap test, RT-PCR of high carcinogenic risk (HCR) HPV. The therapy compliance was evaluated using the clinical psychological test method (Morisky Green scale): compliant patients 4 scores (noncompliant 2 scores or less, insufficiently compliant 3 scores). Results. The therapeutic outcomes using 3,3’-diindolylmethane-containing drug (Cervicon-DIM) in the form of vaginal suppositories (100 mg twice daily for 90 days) showed clinical (recovery of colposcopic status in 83.0% of patients), cytological (confirmed absence of LSIL in 98.3% of women) and microbiological (PCR-negative HCR HPV in 91.5% of women) efficacy with satisfactory tolerance of the drug. Сonclusions. The therapeutic outcomes obtained using 3,3’-diindolylmethane-containing drug in the treatment of patients with HPV-associated low-grade cervical intraepithelial lesion could be considered as satisfactory. The data presented may be of interest to practicing gynecologists and other specialists.

Human papillomavirus infection (HPV) is one of the most common infections today. Young women have a high risk of infection with HPV. The contagiosity of the virus reaches 80%. HPV is a cause of cervical cancer. Genital warts is one of the most common clinical manifestations of HPV, the incidence is 120–150 per 100,000 population. The aim of the study was to assess the degree of incidence of vulvar and vaginal warts, according to the official statistical forms and clinical practice. The statistical forms do not give an accurate account of the incidence of HPV due to the characteristics of reporting. According to clinical observation, signs of HPV were detected in 23,3% of female students, who underwent periodic medical examinations, and in 10,1% of patients, who addressed complaints to the gynecologist. Inosine pranobex is the most studied systemic immunomodulator used to eliminate HPV. The non-intervention open-site single-center study showed that the effectiveness of monotherapy acounted for 66,9%, which categorized inosine pranobex as a first-line drug.

Treatment approach Neoplastic epithelial changes (cervical intraepithelial neoplasia, CIN) can be precancerous. Human papillomavirus is considered to be the cause of neoplastic processes.

The paper presents data on the prevalence of PVI, the recurrence rate of this infection. It discusses various therapy protocols of the disease including the use of destructive methods in the treatment and combination of the above methods with immunomodulating therapy. The own observation data are provided.