Natural history of cervical infection with human papillomaviruses

Human papillomavirus (HPV) is a sexually transmitted virus that has been studied primarily in the context of its role as an epidemiological risk factor for cervical cancer and as a biological agent capable of modifying cellular growth and differentiation. Chronic cervical HPV infection appears to be etiologically linked to neoplastic changes of the cervix. However, it has recently become apparent that HPV is highly prevalent in the general population, including a substantial number of cytologically normal women. Although HPV detection is often transient in these individuals, it is not known whether the virus is truly eliminated or whether it remains below the threshold of detection in a latent state. Little is known about the interaction between HPV and other risk factors for cervical cancer, but it is possible that variables such as pregnancy, immunosuppression, and use of oral contraceptives may alter the natural history of HPV infection.