HPV Vaccination Concepts in the Reality of Today

The aim of this review is to evaluate the complex interaction between HPV and human body, in order to contextualize its role in the development of infective-related disease and neoplastic transformation. While the clinical value of vaccination on the field of gynecology has been widely investigated, the growing introduction of universal coverage (both males and females) leads to the need to extend investigations to adjunctive areas of interest. This is the rationale to extend and combine in a single review the main emerging areas where the HPV vaccination could induce an effective immunological response: HPV-related upper aerodigestive tract (UADT) pathologies, and HPV-related alterations of reproductive processes in males and females. There is no doubt that universal vaccination against HPV (9vHPV) is demonstrating its effectiveness in the prevention of most HPV-related conditions and worldwide prevalence data allow us to consider HPV vaccination from adolescence to late adulthood. We can conclude that: i) HPV infection is still very prevalent in sexually active population and may be associated to cervical, oropharyngeal, penile and anal cancers; ii) due to HPV vaccination and screening for cervical cancer, the incidence of cervical carcinoma is strongly decreased; iii) the rate of oropharyngeal cancer is growing worldwide and since 2010 it represents in males the most frequent HPV related cancer among U.S. population; iv) HPV semen infection, has been related to impaired sperm parameters, higher miscarriage rate and, in general, to couple infertility both by natural and assisted conception; v) recent efforts toward a universal vaccination against HPV have demonstrated its effectiveness in the prevention of most HPV-related conditions; vi) growing evidences suggest positive effects of adjuvant vaccination in patients with HPV related cancer and in HPV infected infertile couples.