Hellner Karin, Dorrell Lucy
Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Women's Centre, John Radcliffe Hospital, Oxford, UK.
Nuffield Department of Medicine, University of Oxford, NDM Research Building, Old Road Campus, Headington, Oxford, UK; Oxford NIHR Biomedical Research Centre, University of Oxford, The Joint Research Office, Block 60, Churchill Hospital, Old Road, Headington, Oxford, UK.
F1000Res. 2017 Mar 14;6. doi: 10.12688/f1000research.9701.1. eCollection 2017.
High-risk human papillomaviruses (hrHPV) are responsible for anogenital and oropharyngeal cancers, which together account for at least 5% of cancers worldwide. Industrialised nations have benefitted from highly effective screening for the prevention of cervical cancer in recent decades, yet this vital intervention remains inaccessible to millions of women in low- and middle-income countries (LMICs), who bear the greatest burden of HPV disease. While there is an urgent need to increase investment in basic health infrastructure and rollout of prophylactic vaccination, there are now unprecedented opportunities to exploit recent scientific and technological advances in screening and treatment of pre-invasive hrHPV lesions and to adapt them for delivery at scale in resource-limited settings. In addition, non-surgical approaches to the treatment of cervical intraepithelial neoplasia and other hrHPV lesions are showing encouraging results in clinical trials of therapeutic vaccines and antiviral agents. Finally, the use of next-generation sequencing to characterise the vaginal microbial environment is beginning to shed light on host factors that may influence the natural history of HPV infections. In this article, we focus on recent advances in these areas and discuss their potential for impact on HPV disease.
高危型人乳头瘤病毒（hrHPV）是肛门生殖器癌和口咽癌的致病因素，这两类癌症合计占全球癌症总数的至少5%。近几十年来，工业化国家得益于预防宫颈癌的高效筛查，然而，数百万低收入和中等收入国家（LMICs）的妇女仍然无法获得这一关键干预措施，她们承受着HPV疾病的最大负担。虽然迫切需要增加对基本卫生基础设施的投资并推广预防性疫苗接种，但现在有前所未有的机会利用筛查和治疗hrHPV癌前病变的最新科技进展，并使其适用于在资源有限的环境中大规模推广。此外，治疗宫颈上皮内瘤变和其他hrHPV病变的非手术方法在治疗性疫苗和抗病毒药物的临床试验中显示出令人鼓舞的结果。最后，利用下一代测序来表征阴道微生物环境，开始揭示可能影响HPV感染自然史的宿主因素。在本文中，我们重点关注这些领域的最新进展，并讨论它们对HPV疾病产生影响的潜力。
