Human papilloma virus – achievements and prospects

Abstract

Human papillomavirus (HPV) infection is a major risk factor for cervical cancer. Incorporation of HPV testing into the present Pap screening program has the potential of making screening for cervical cancer more effective. In this article we review the mechanisms and the effectiveness of Bivalent (HPV-16/-18) and Quadrivalent (HPV-6/-11/-16/18) HPV vaccine cross-protection, focusing on the critical aspects and the potential biases in clinical trials, in order to understand how cross-protection could impact on clinical outcomes and on the new perspectives in post-vaccine era. The review covers new therapeutic points aimed at future: the Japanese herbal medicine (Juzen-taiho-to and Hochu-ekki-to) that have been shown to enhance humoral immune responses to vaccine antigen when used as adjuvants for prophylactic vaccines, and Imiquimod (enhances the immune response to HPV-induced genital warts) which cervical application is an adjunct to standard treatment for cervical dysplasia.

Keywords:human papillomavirus (HPV), HPV testing, cervical cancer screening, Pap smear, cervical dysplasia, loop electrosurgical excision procedure, HPV therapeutic vaccine, quadrivalent vaccine, bivalent vaccine, cross-protection, mucosal immune response, Lactobacillus-based vaccine, japanese herbal medicines, oral immunization, imiquimod