Epidemiologic and mucosal immunologic aspects of HPV infection and HPV-related cervical neoplasia in the lower female genital tract: A review

Human papillomavirus (HPV) infections are known to play an important role i n the pathogenesis of cervical neoplasia. Considering the morbidity and mor tality of cervical cancer, infection with HPV can be regarded as a worldwid e problem, especially in developing countries. Currently, many studies focu s on the development of both prophylactic and therapeutic HPV vaccines. Cru cial for these vaccination protocols to be successful is that they will res ult in a long-lasting ability to generate an immune response that will elim inate the virus. HPV transmission and subsequent infection is a local event in the lower female genital tract and therefore the efficacy of vaccines a gainst this locally transmitted infection can be best assessed by parameter s of local immunity. In this review we describe both the epidemiology of HP V-related cervical neoplasia and the general aspects of mucosal immunity in the female genital tract while focusing on the local humoral immunity in H PV-related cervical neoplasia.