The human Papillomavirus twilight zone-Latency, immune control and subclinical infection

被引:18
作者
Doorbar, John [1 ]
机构
[1] Dept Pathol, Div Virol, Tennis Court Rd, Cambridge CB2 1QP, England
来源
TUMOUR VIRUS RESEARCH | 2023年 / 16卷
基金
英国医学研究理事会;
关键词
COTTONTAIL RABBIT PAPILLOMAVIRUS; SKIN PAPILLOMAVIRUSES; REGRESSION; TRANSFORMATION; PATHOGENESIS; DISEASE; BIOLOGY; WOMEN; MODEL; RISK;
D O I
10.1016/j.tvr.2023.200268
中图分类号
Q93 [微生物学];
学科分类号
071005 ; 100705 ;
摘要
The incorporation of HPV DNA testing into cervical screening programs has shown that many HPV-positive women are cytologically normal, with HPV-positivity fluctuating throughout life. Such results suggest that papillomaviruses may persist in a latent state after disease clearance, with sporadic recurrence. It appears that virus latency represents a narrow slot in a wider spectrum of subclinical and possibly productive infections. Clinical studies, and animal model infection studies, suggested a key role for host immune surveillance in maintaining such asymptomatic infections, and although infections may also be cleared, most studies have used the term 'clearance' to describe a situation where the presence of HPV DNA falls below the clinical detection level. Given our knowledge of papillomavirus immune evasion strategies and the restricted pattern of viral gene expression required for 'basal cell' persistence, the term 'apparent clearance' and 'subclinical persistence' of infection may better summarise our understanding. Subclinical infection also encompasses the lag phase, which occurs between infection and lesion development. This is dependent on infection titre, with multifocal infections developing more rapidly to disease. These concepts can usefully influence patient management where HPV-positivity occurs sometime after the onset of sexual activity, and where vertical transmission is suspected despite a lag period.
引用
收藏
页数:9
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