Assessment of exposure to sexually transmitted agents other than human papillomavirus

There are now a number of lines of evidence giving support for a causal role of high-risk oncogenic HPV types in cervical cancer. However, it is clear that only a minority of women with HPV 16 infection, for example, develop invasive cancer. Therefore examination of whether sexually transmitted agents other than HPV are interacting in the genesis of cervical neoplasia is necessary. Serological methods which accurately reflect past exposure to individual agents are ideal for epidemiological studies. Sensitive and specific assays that are available for HSV 1, HSV 2, Treponema pallidum, CMV, HIV and Chlamydia are reviewed. Some data suggest an interaction of herpesviruses with HPV in oncogenesis which future epidemiological studies should address. However, at present the evidence is inadequate to prove the involvement of sexually transmitted agents other than HPV in the etiology of cervical neoplasia.