Biomarkers for detection of human papillomavirus (HPV)

The role of human papillomaviruses (HPVs) in the aetiology of invasive cervical carcinoma has been well established. At least 13 genotypes have been found to be associated with the risk to develop cervical cancer. Several biomarkers have been recognized which roughly identify specific stages in the natural history of HPV infection and cervical cancer progression. They include the presence of viral proteins, viral nucleic acids or alteration of cellular features induced by viral oncoproteins. In the context of screening, good sensitivity of test has to be balanced against the test's specificity. Specificity is particularly important in cervical cancer screening because screening involves large numbers of otherwise healthy women, and positive results require a follow-up colposcopic evaluation that is both uncomfortable and costly. The two methods, i.e. testing for nucleic acids of high-risk HPVs or the cellular surrogate markers of HPV, are the primary cervical cancer screening method in many countries. Unfortunately, CIN2 and CIN3 are the endpoint of all the available studies and the target of treatment. New biomarkers such as viral and cellular methylation profiles could represent the most accurate markers for cancer progression with high sensitivity and specificity in near future.