Human papillomaviruses: Diseases, diagnosis, and a possible vaccine

The human papillomaviruses (HPVs) are a family of more than 80 serotypes that cause pathologies, including common and genital warts. Long-term infections of the cervix, penis, anus, or larynx by the “high-risk” HPV serotypes (usually HPV-16 or -18) cause dysplasia that can progress to cancer. These lesions can be detected and treated, if a high level of medical care is available. However, HPV-associated cervical cancer remains a major cause of death in medically underserved populations, particularly in the developing world. Because HPVs are difficult to grow in cell culture or animal models, less is known about them than other pathogens of equal importance. The major theme of HPV treatment is that while no effective antiviral drugs are yet available, a healthy immune response can clear or contain the infection. Thus, current treatment procedures are based on surgical removal of the infected cells and/or boosting the patient's immune system to destroy them. An effective prophylactic HPV vaccine could address much of the morbidity and mortality currently associated with cervical dysplasia and cancer. Recently, a novel avenue of HPV vaccine research that uses noninfectious virus-like particles (VLPs) has yielded promising results. At least one candidate VLP vaccine is expected to be submitted for FDA approval by 2010.