The papillomaviridae are ancient and ubiquitous viruses, with over 200 types of species-specific viruses classified into 16 genera. Papillomaviruses preferentially infect differentiating squamous epithelium and in humans, and almost every part of human skin can be infected. HPV was the first known human tumour virus, associated with benign, epithelial proliferations or papillomas and there are now 120 different HPV types officially recognised with others pending classification. In recent decades, the causal association of HPV with cervical cancer, but also with an increasing number of squamous cell carcinomas at specific sites, has been recognised. This paper sets out the range of infections and clinical manifestations of the consequences of infection and its persistence.
The range of infections, precancers and malignancies associated with HPV continues to grow. While much effort worldwide focusses on the potential to eradicate cervical cancer by HPV vaccination programmes targeting pre-sexually active girls, the burden of disease is increasing in other areas, particularly with the high prevalence of genital warts and of anal and oropharyngeal cancers, in both men and women. It is important also to recognise the morbidity of cutaneous HPV lesions, particularly in the immunosuppressed population. HPVs remain both highly effective pathogens and carcinogens, well adapted to their ecological niches, capable of avoiding immune responses and therefore challenging to eliminate.
Diseases associated with human papillomavirus infection. (2013) Virology pii: S0042-6822(13)00356-5. doi: 10.1016/j.virol.2013.06.007
Human papillomaviruses (HPVs) are ubiquitous, well adapted to their host and cleverly sequestered away from immune responses. HPV infections can be productive, subclinical or latent in both skin and mucosa. The causal association of HPV with cervical cancer, and increasingly with rising numbers of squamous cell carcinomas at other sites in both men and women, is increasingly recognised, while the morbidity of cutaneous HPV lesions, particularly in the immunosuppressed population is also significant. This chapter sets out the range of infections and clinical manifestations of the consequences of infection and its persistence and describes why HPVs are both highly effective pathogens and carcinogens, challenging to eliminate.