Immunologic responses to human papillomavirus infection

The immune mechanisms following papillomavirus infections are barely characterized. However, the association of serum antibodies to HPV proteins with HPV-related diseases is now well-established. Antibodies to some early viral proteins but also to virus capsids (as measured by using VLPs) are found in a significant proportion of patients with benign and malignant HPV-related diseases. A small number of patients, however, are devoid of detectable antibodies. It is not clear whether the missing immune response is of any biologic significance for the patient or merely reflects differences in antigen presentation during the course of infection. Clearly, the relatively low sensitivity of serologic assays renders them unsuitable for diagnostic purposes. However, certain combinations of assays may reach a higher predictive value, and hence a particular disease may be diagnosed by a pattern of positive (and negative?) reactions. The humoral immune response in patients with subclinical infections is less well characterized, but such studies are currently being performed in different laboratories.