Epidemiology and Natural History of Human Papillomavirus Infections in the Female Genital Tract

[摘要] Human papillomavirus (HPV) is the most common newly diagnosedsexually transmitted infection in the United States. Although themajority of sexually active adults will be infected with HPV atleast once in their lives, it is sexually active women less than25 years of age who consistently have the highest rates ofinfection. Besides youth and gender, common risk factors for HPVinfection and clinical sequelae of infection include high numberof sexual partners and coinfection withChlamydiatrachomatisor herpes simplex virus. Most HPV infections arecleared by the immune system and do not result in clinicalcomplications. Clinical sequelae in cases of low-risk HPVinfection consist of genital warts, and clinical manifestations ofhigh-risk HPV infection include abnormal Pap test results,low-grade squamous intraepithelial lesions (LSIL), high-gradesquamous intraepithelial lesions (HSIL), and cervical cancer.LSIL, HSIL, and cervical cancer carry significant morbidity and/ormortality; genital warts and abnormal Pap test results are oftensignificant sources of psychosocial distress. Currently, there areneither effective means of preventing HPV transmission nor curesfor clinical manifestations: infection can only be prevented viacomplete sexual abstinence, while treatment for clinical sequelaesuch as genital warts and cytologic abnormalities consists ofremoving the problematic cells and watching for recurrence; thismethod consumes significant health care resources and is costly.New prophylactic HPV vaccines promise to dramatically reduce theincidence of HPV infection, genital warts, and cytologicabnormalities.

[学科分类] 妇产科学