Is HPV infection serious and how should it be treated?

  (1) Three groups of proteins recognized as capable of inducing an immune response in the body: (1) Viral oncogenes E6 and E7 proteins, which can be consistently expressed in cervical cancer.  (2) Other early proteins, such as E1, E2, E4 and E5. (3) Viral capsid proteins L1 and L2, which are expressed in the epithelial basal layer. The capsid proteins have the ability to self-assemble into virus-like particles, and most preventive vaccines use VLP as the target antigen. It is an ideal subunit vaccine for prevention.  VLP consists of viral structural proteins and does not contain viral DNA or oncoproteins. It is highly immunogenic while not triggering viral infection in the body as a result of vaccination, and has a high safety profile and is suitable for people who are not infected with HPV. The most studied vaccine is the VLP vaccine consisting of L1 alone. Because Ll is highly specific and conserved, HPV antibodies against Ll VLP are type-specific; another combination vaccine composed of L1 and L2 is more effective than Ll alone due to cross-protection against other types, but it is not advantageous in terms of preparation and cost, and this combination vaccine is currently under research; the less studied chimeric vaccine is a combination of other The less studied chimeric vaccine is a vaccine that integrates other non-structural proteins into VLP to induce cellular immune response, which is a vaccine with both preventive and therapeutic effects, and its effectiveness and safety still need to be confirmed by further research.  2. The optimal age for vaccination is not yet available in China for primary prevention of cervical cancer. Internationally, the best time for preventive vaccination is before entering the sexually active stage and potentially exposed to HPV. Two preventive vaccines have been approved for marketing by the European and US Food and Drug Administration (FDA).  One vaccine is a quadruple vaccine for types 6, 11, 16, and 18, and the other is a bimodal vaccine for types 6 and 7. Clinical trials have demonstrated good tolerability and no serious adverse reactions, and high antibody potency of the vaccine. The effectiveness of the vaccine decreases with increasing number of sexual partners and age. The clinical use of the quadrivalent vaccine was selected for women aged 9-26 years, and studies have been conducted on the effectiveness of the vaccine in groups of women aged 26-55 years with a high history of previous HPV infection, which is important for the development of relevant health policies.  3. Problems with the HPV vaccine HPV vaccination has greatly increased the options for preventing cervical cancer, but there are many challenges for resource-poor regions. The price of the vaccine is still too high for most developing and poor countries, and there are no studies for infants. Because of these constraints, existing HPV vaccines cannot be approved for inclusion in the Expanded Programme on Immunization (EPI), which has been successfully rolled out and covers most resource-poor countries.  Studies have shown that the type of HPV infection varies by region, population, and ethnicity, which determines the overall effectiveness of the HPV vaccine once it is introduced to the market, and that vaccination may cause a change in the underlying infection type. For areas with better screening, the greatest benefit of the vaccine is in reducing the cost of diagnosing and treating precursor lesions of cervical cancer, while women who are not routinely screened are often not in a position to receive the expensive vaccine. The current injectable vaccine is expensive and requires advanced technology and special equipment to manufacture and stockpile, making it difficult to scale up in low- and middle-income countries in the context of national conditions, and further research is needed for easier and more economical immunization routes and vaccine storage.