Humani papilomavirusi i karcinom grlića materice iz perspektive inicijative Svetske zdravstvene organizacije za eliminaciju karcinoma grlića materice
Sažetak
Humani papilomavirusi (HPV) su među najčešćim uzročnicima seksualno prenosivih patogena i mogu dovesti do različitih kliničkih manifestacija: od benignih stanja do različitih vrsta karcinoma kod žena, ali i muškaraca. Najčešći HPV-posredovan karcinom je karcinom grlića materice koji je u preko 99,99% slučajeva posledica infekcije. Najefikasniji način da se spreči razvoj perzistentne HR-HPV infekcije je vakcinacija. Dostupne su tri profilaktičke vakcine: dvovalentna, kvadrivalentna i devetovalentna. Devetovalentna vakcina pruža najširu zaštitu jer sadrži devet onkogenih HPV genotipova i postepeno zamenjuje ostale vakcine u svim zemljama. Sa vakcinacijom se može krenuti od 9. godine, ali se najčešće rutinski sprovodi kod dečaka i devojčica u uzrastu od 11 do 12 godina. Svetska zdravstvena organizacija je prepoznala karcinom grlića materice kao globalni problem i uvela takozvanu 90-70-90 strategiju u cilju smanjenja stope, pa čak i eliminacije karcinoma grlića materice. Ova strategija podrazumeva da 90% devojčica bude potpuno vakcinisano do 15. godine, 70% žena pristupi redovnom ginekološkom pregledu do 35. godine i ponovo do 45. godine i 90% žena sa promenama na grliću materice primi adekvatnu terapiju. Iako su dostupne različite terapije poput hirurškog tretmana, radioterapije, hemioterapije i ciljane terapije monoklonskim antitelima, i dalje su potrebni veliki napori da bi se dostigli ciljevi Svetske zdravstvene organizacije.
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