Chapter category: Vaccines
Immunomodulation of HPV Infection and Disease: An Overview
Vaccines for Human Papilloviruses Infection and Anogenital Disease
Edited by: Robert W. TindleISBN: 1-57059-589-5
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Chapter authors:
Robert W. Tindle
About 50 of the approximately 100 (the number continues to grow) genotypes of human papillomaviruses (HPV) infect the mucous epithelium of the genital tract. HPV genotypes 6, 11, 43 and 44, in particular, predispose individuals to noninvasive flat or hyperkeratotic condylomata (genital warts) and low grade dysplasia. New reported cases of genital warts exceed one million per annum in the USA. Current drug therapies include local injection of interferon-•, topical podiphyllotoxin and imiquimod with or without cryotherapy, and laser ablation or surgical excision. The limitations of the current ablative and drug approaches (recurrence rates are typically 25-50%) in control of disease indicates that immunomodulatory approaches to prevent infection and disease progression are warranted. It is less than clear, however, how this might be approached, since a majority of the sexually active population is infected with anogenital-associated HPV, asymptomatically.1 The quest for HPV vaccine(s) is also driven by the association of HPV infection with carcinoma of the uterine cervix.2 HPV DNA (predominantly genotypes 16, 18, 45) is detected in more than 90% of all uterine cervical tumors.3 Some 500,000 new cases of cervical carcinoma are reported annually worldwide. It is estimated that 0.1-1% of HPV infections would progress to neoplastic disease if left untreated. However, while recurrence of genital warts is a problem in the developed world, 80% of cervical cancer occurs in developing countries (where it is frequently the major cause of mortality in women) which lack full availability of Pap screening programs, surgery and radiotherapy. Typically, cervical cancer ranks fourth to eighth as the cause of death in countries where these services are available. It is clear that immunomodulatory approaches will only make inroads into the global burden of cervical cancer if immunotherapy is combined with immunoprophylaxis.
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About 50 of the approximately 100 (the number continues to grow) genotypes of human papillomaviruses (HPV) infect the mucous epithelium of the genital tract. HPV genotypes 6, 11, 43 and 44, in parti...
