[Vaccination against human papillomavirus infections]

The aim of vaccination against human papillomaviruses is to fight against benign lesions as well as cancers. Two vaccine strategies have been developed: therapeutic vaccines that induce cytotoxic T cells with the ability to eliminate infected/tumoral cells, and prophylactic vaccines that induce the production of neutralizing antibodies preventing HPV to infect their target cells. While the therapeutic strategies give good results in mouse model, their efficiency in human remains to be demonstrated. In contrast, data regarding prophylactic vaccines, already promising in animal models, show a significant benefit as no HPV16 nor 18 associated high grade lesions of the cervix occurred in vaccinated subjects participating to ongoing clinical trials. Who is going to vaccinate? What is the best target population to vaccinate, at which age? With or without a booster? And what about developing countries? Several issues remain to be addressed for an efficient implementation of HPV vaccination.