HPV Infections: Basis of Neoplastic Transformation and Related Molecular Tests

Cervical cancer is a major health problem and almost all of these cancers are related to a high risk Human Papillomavirus cervical infection. The Human Papillomavirus transforming potential has long been probed and is mainly characterized by the integration of the virus in the host genomes and the expression of the viral oncoproteins such as the E6 and E7 mRNAs. The vast majority of the HPV infections are transient and resolve and just a few percentages of patients are noted to develop a persistent infection. Therefore, there is the need of identifying appropriate biomarkers that can predict and differentiate transient vs persistent and clinical relevant HPV cervical infections. To date, two categories of commercial assays have been introduced, mainly aiming to the detection of the E6 and E7 mRNAs and of the surrogates of the E7 activity (p16ink4A protein). The aim of the present study is to analyse the basis of the HPV-related carcinogenesis and to discuss the commercial biomarkers developed to-date, reviewing those studies that used the above-mentioned assays in a clinical setting.