Some immunological parameters of cervicovaginal secretion and blood serum in women with HPV mono- and mixed infections in the Amur Region

Introduction. Human papillomavirus (HPV) infection negatively affects the female immune system, with severity exacerbated by microbiome disruption and concomitant sexually transmitted infections (STIs).

Aim. To assess the levels of immunoglobulins (Ig) A, G, and M in cervicovaginal secretion and blood serum in women with monoand mixed HPV infection in Amur region.

Materials and methods. A prospective comparative study included 134 women of reproductive age: 100 with confirmed HPV infection (38 with mono-infection and 62 with mixed infection) and 34 HPV-negative controls. Comprehensive analysis included clinical and anamnestic data, polymerase chain reaction–based HPV genotyping and viral load assessment, and enzyme-linked immunosorbent assay (ELISA) for IgA, IgG, and IgM in both serum and cervicovaginal secretion.

Results. The most prevalent HPV types were 16 (26%), 51 (24%), 56 (20%), and 18 (18%). Co-infection with two or more genotypes was detected in 31% of cases. High viral load was observed in 62% of HPV-positive women. Concomitant STIs (chlamydia, cytomegalovirus, herpes simplex virus type 2) were diagnosed in 25%, and significant dysbiosis was present in 26% of HPV-infected women. In cervicovaginal secretion, IgA levels were reduced 1.4-fold in mono-infection and 1.7-fold in mixed infection compared to controls (p < 0.001); in mixed infection, IgA was 1.3-fold lower than in mono-infection (p < 0.05). Similarly, serum IgA decreased 1.6-fold and 1.7-fold, respectively (p < 0.001). IgG in secretion was 1.6-fold lower in mono-infection and 1.7-fold lower in mixed infection; in serum, reductions were 1.8-fold and 2.0-fold, respectively (p < 0.001). IgM levels in the mixed infection group were 1.7- fold higher than in the mono-infection group (p < 0.001).

Conclusion. HPV infection, particularly in mixed form, is associated with marked suppression of both local and systemic humoral immunity. Alterations in IgA, IgG, and IgM levels correlate with infection pattern: mixed infection creates conditions favorable for prolonged viral persistence.

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