Pathogenesis of infection by human papillomavirus

Human papillomaviruses (HPVs) are associated with benign lesions known as warts and several cancer types including cancer of the cervix, penis, anus and oral cavity. HPVs are classified by their oncogenic potential and are divided into high-risk oncogenic HPVs and low-risk HPVs. Tissue tropism is used as another means of classifying the virus, and HPVs are divided into types that infect mucosal or cutaneous tissues. Several risk factors have been identified that elevate an individual's likelihood of becoming infected with HPV including cigarette smoking, a large number of lifetime sexual partners and immunosuppression. Most HPV infections are cleared naturally, although persistent infection with oncogenic HPV types can lead to the cancers mentioned above. HPV has employed several mechanisms to avoid detection by the host immune system. Virus is released along with shedding skin cells in a nonlytic manner, and the virus has an altered codon usage leading to reduced expression of viral proteins. Infections from high-risk oncogenic HPV types that progress cause neoplasias that are defined as CIN1-CIN3 depending on the amount of abnormal cell growth and the level of cellular differentiation.