Efficacy of preventive human papillomavirus vaccination

Interplay between host immune system and expression of human papillomavirus (HPV) early (E) and late (L) genes during infection has a central role in the surveillance of virus-induced neoplastic cervical lesions. Recently, ne w features of this interplay have been discovered. However, not enough is y et known of the relative roles of different E and L proteins, human lymphoc yte antigens (HLAs) and specific co-factors in the natural history of these lesions in order to guarantee efficacy of preventive HPV vaccination. The ultimate knowledge can only be provided by phase III/IV vaccination trials which are starting in the near future. The present review attempts to answe r one fundamental question: which of the vaccine candidates is likely to be most successful.