HPV and intraepithelial neoplasia of the lower genital tract

Human papilloma virus (HPV) is the key factor in the development of cervica l carcinoma and its precursor lesions. HPV-DNA was detected in 99.7% of all invasive cervical carcinomas from 22 countries [26]. Numerous in-vitro and in-vivo studies have demonstrated the transforming potential of this virus . The oncogenes E6 and E7 of HPV types 16 and 18 were classified as carcino gens by the IARC as early as 1995. The latest findings indicate that this i s also true of the E6 and E7 genes of other so-called high-risk HPV types [ 28]. Persistent infection with a high-risk HPV is an essential prerequisite for the development of cervical intraepithelial neoplasia (CIN) III (4, 15 ). However, co-factors are also essential for this process. These have not yet been adequately characterised. It is, however, certain that immunosuppr ession,smoking,and other genital infections (best defined in the case of Ch lamydia) are important. Meanwhile,the value of HPV testing both for screeni ng and for the assessment of patients with abnormal cytological smears is w ell established (15).