Immunology of human papillomavirus infection in lower genital tract neoplasia

Despite its being a relatively common virus, the study of human papillomavi rus infection has lagged behind that of other viruses. Human papillomavirus es do not provoke strong systemic antibody or T-cell responses. Furthermore , the majority of those infected do not display clinical symptoms and are a ble to clear the virus by unknown mechanisms. In the last decade, however, research into human papillomavirus immunology has blossomed, for two main r easons. First, there is strong circumstantial evidence that the immune syst em can control papillomavirus infection, since the prevalence of human papi llomavirus-associated neoplasia is increased in immunocompromised individua ls. Second, the strong association between human papillomavirus infection a nd cervical cancer has led to attempts to develop prophylactic or therapeut ic vaccines. In this chapter, our current knowledge of human papillomavirus immune responses will be reviewed, and how this relates to clinical practi ce will be discussed.