Immunology of anogenital human papillomavirus (HPV) infection

A subgroup of human papillomaviruses (HPVs) is implicated in the aetiology of neoplastic change in anogenital epithelium. Although abundant circumstantial evidence exists for the involvement of the immune system in the control of HPV infection, restriction of infection to epithelium and the lack of a viral productive phase pose problems for immune response induction, and for immunological effector mechanisms. In this article we discuss how HPV antigens may be presented to the immune system on the surface of keratinocytes as well as, or in addition to, presentation by 'classical' antigen presenting cells, and outline putative roles for non-specific and specific (B- and T-cell) effector functions. We discuss the prospects for a vaccine and the use of anti-HPV antibodies in immunodiagnosis.