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Abstract
Infection with certain types of human papillomavirus (HPV) is casually associated with the development of cervical cancer and other anogenital neoplasia. There is increasing evidence of a wider association with other epithelial cancers. The availability of recombinant molecular biological techniques has circumvented the difficulties in studying the virus life cycle that is critically dependent on the differentiation of the epithelial target cell. From an understanding of the virology and cell biology of HPV infection, prospects for diagnostic and screening procedures in cervical neoplasia are being tested. The prize is the cost effective estimation of risk from HPV infection. New approaches need to be compared to existing and proven, although not perfect, smear test screening methods for prevention of cervical cancer. Novel research and development activities aimed at treating HPV infections in early premalignant lesions are utilising aspects of interference with early viral gene expression, or their co-ordinate cellular targets. Many immunological approaches with the goal of prevention of infection (prophylactic vaccination) or therapy of early cervical lesions are being tested. A virus-like particle composed of HPV L1 or L1/L2 capsid proteins, formulated to generate neutralising antibodies, is a key technology. Chimeric variations delivering other target antigens that can stimulate cytotoxic T-lymphocyte (CTL) activity may have wider applications in cancer treatments. Immunotherapeutic strategies aimed at treating late stage disease by optimising the stimulation of CTL versus HPV oncogenes is another major area of activity. Clinical trials testing the safety and efficacy of some of these inventions are in progress.