Abstract

Viral infections cause at least 15% of all cancers; one of the most important oncogenic viruses is the human papillomavirus (HPV) a causal agent in 4% of all cancers. The identification of the major oncogenic HPV ’s HPV 16 and HPV 18 by Harald zur Hausen was recognised in 2008 by the award to him of the Nobel Prize in Medicine. The unfolding of the HPV story started in the 1970’s and has resulted in the development of prophylactic vaccines using sophisticated recombinant molecular techniques and protein expression to prevent infection by HPV 16 and 18. These vaccines are now licensed world wide and have been incorporated into national immunisation programmes in several countries The vaccines are remarkably efficacious, generate strong immunity and have a very good safety profile. Providing these vaccines are delivered as part of an organised immunisation programme and achieve high coverage they should significantly reduce the incidence of cervix cancer, and other HPV associated cancers, in the vaccinated cohort over the medium to long term. However since the current vaccines provide protection only against the 2 major oncogenic HPVs 16 and 18 that cause 70-80% of cervix cancers, complete protection against HPV caused cervical cancer will require polyvalent vaccines or broadly protective products in the future. Recent data on the mechanism of viral entry and the dynamics of the interaction of the viral capsid proteins L1 and L2 with the cell surface provide a rationale for the design of second generation vaccines.