The biology and significance of human papillomavirus infections in the genital tract.

A variety of human papillomavirus (HPV) types infect the anogenital mucosa, giving rise to lesions that differ in clinical appearance, histology, and risk of malignant progression. Certain high-risk types (HPVs 16, 18, 31, 33, 35 and 39) have a strong association with high-grade epithelial neoplasia and invasive carcinomas of the anogenital tract. Cancer appears to have a multifactorial etiology, and HPV infection alone is probably insufficient for malignant transformation. The consistent association between HPV infection and anogenital cancers emphasizes, however, that the sexually transmitted papillomaviruses may have a necessary role in carcinogenesis. Hence, there is a prospect that vaccination programs may one day allow public health control of HPV infection, thereby eliminating an important risk factor.