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1219 Use and effect of lactobacilli in women with high risk HPV infection
  1. Katerina Madjunkova
  1. Policlinic Martini, Strumica, North Macedonia


Introduction/Background The female reproductive tract, similar to other mucosal sites, has a specific microbiome, which plays an essential role in maintaining health. Changes in the vaginal environment lead to multiple gynecological diseases, including cervical cancer. HPV persistent infection is a main reason for development of cervical intraepithelial neoplasia and cervical cancer. In the majority of women in reproductive age, the microbiota of the vagina and cervix is dominated by Lactobacillus species (spp.). The vaginal microbiome may affect the persistence of HPV infection and the development of cervical disease. A number of studies suggested that Lactobacillus spp. depletion is increased in women with cervical disease.

Probiotics comprise living bacteria that can modulate the composition of microbiota in an attempt to improve the health.

Methodology In 46 months, we followed up 28 women on age between 24 and 43 from 2020 until 2023. 20(71.42%) of them had HPV infection 16 and 18, without cervical lesion, and 8 (28.57%) that were on the age of 28–32 years old, had the same HPV infection with low cervical dyplasia. All of them were treated with vaginal and oral use of Lactobacilli, we were maintaining normal vaginal pH all the time. Patients with bacterial and yeast infection were treated with antibiotics and antimicotics. All were examined with pap smears, cervical biopsies, vaginal pH, bacterial smears.

Results 27(96.42%) of the examined patients didn’t develop cervical dysplasia, only one patient, age 40 (3,57%) had cervical dysplasia gradus mediocris where laser conisation was performed. Others didn’t develop cervical dysplasia (p<0.05), and 16 (57%) of the women had HPV clearance.(p<0.05)

Conclusion Higher percentage of clearance of PAP-smear abnormalities in patients who took long term oral and vaginal Lactobacillus. Vaginal pH and use of Lactobacilli plays main role on effect on HPV infection. Better understanding of microbiome may help the development of new therapeutic agents.

Disclosures Probiotics by alterations in pH, inhibition of pathogens and maintenance of the mucosal barrier has important role in woman heath. Further investigations are needed to improve the therapeutic agents.

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