Natural HPV immunity and vaccination strategies

Background: the task of preventing premature death in women map be delivere d by vaccinating against the high-risk papillomaviruses associated with var ious malignancies. Objectives: we will discuss the immune mechanisms likely to be relevant to the control of an HPV infection in the cervix and assess the limited evidence for such immune recognition in the natural history of infection. Conclusion: the next generation of vaccination strategies shoul d include the use of HPV 16 early (E2 and/or E6 and/or E7) and late gene ta rgets (L1 and L2) expressed as VLPs with their clinical and immunological e valuation aimed at therapy as well as prophylaxis. Important clinical effic acy assessment may be deliverable in relatively short-term studies by targe ting patients with HPV 16 associated vulval intraepithelial neoplasia. (C) 2000 Elsevier Science B.V. All rights reserved.