The Impact of Human Papillomavirus Biology on the Clinical Practice of Cervical Pathology

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Abstract
Human papillomaviruses are present in virtually all cervical cancers and cancer precursors. The transcriptional activity of the virus and the interactions of viral proteins with the epithelial cell determine the pathology of cervical neoplasia. Morphologic criteria are understandable relative to the 2 phenotypes of viral-host interaction (ie, a productive versus a proliferative phenotype). However, the subjective nature of morphologic interpretation has led to an increased utility of HPV and other molecular tests to increase both sensitivity and specificity of cervical cellular diagnosis. The development of HPV vaccines promises to dramatically impact the natural history of HPV infection.