Crawford L
ICRF Tumour Virus Group, University of Cambridge.
Cancer Surv. 1993;16:215-29.
As we have seen, the technical problems of developing cheap, effective vaccines against HPV associated tumours are formidable, but they are by no means insuperable. Experiments in cows with BPV2 show that both therapeutic and prophylactic vaccines work to some extent and the immunogens used are by no means the best that could now be envisaged. The fact that human trials are now under consideration or in progress with both protein vaccines and recombinant vaccinia virus vectors is also very encouraging. There are still both practical and ethical problems, as with any sexually transmitted disease, but the main problem is one of support. Pharmaceutical companies see no immediate profit in vaccines of this type, preferring to invest in drugs for treatment or diagnostic kits for detection. Vaccines against HPV are unlikely to be forthcoming, and indeed, the people most in need of protection against cervical cancer are the least able to afford any sort of treatment, especially a preventive one. This leaves the cancer charities, and these in their present financial difficulties are understandably reluctant to commit substantial resources to the long term programmes that are needed to tackle the problems of developing and evaluating candidate vaccines. It seems certain that intervention against HPV and cervical cancer will come in time, but with the present level of commitment, progress is inevitably going to be less rapid than one would like.
如我们所见，研发针对与人乳头瘤病毒（HPV）相关肿瘤的廉价、有效疫苗存在巨大的技术难题，但绝非无法克服。在感染牛乳头瘤病毒2型（BPV2）的奶牛身上进行的实验表明，治疗性疫苗和预防性疫苗在一定程度上均有效果，而且所使用的免疫原绝非目前所能设想的最佳免疫原。目前正在考虑或进行蛋白质疫苗和重组痘苗病毒载体人体试验这一事实也非常鼓舞人心。与任何性传播疾病一样，仍然存在实际问题和伦理问题，但主要问题是支持力度不足。制药公司看不到这类疫苗能带来立竿见影的利润，更愿意投资于治疗药物或检测诊断试剂盒。针对HPV的疫苗不太可能很快问世，而且实际上，最需要预防宫颈癌的人群最无力承担任何形式的治疗，尤其是预防性治疗。这就只能依靠癌症慈善机构了，而鉴于它们目前的财务困境，它们不愿为开发和评估候选疫苗所需的长期项目投入大量资源是可以理解的。干预HPV和宫颈癌问题肯定迟早会实现，但就目前的投入水平而言，进展必然会比人们期望的要慢。
