{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:49:26Z","timestamp":1790837366778,"version":"4.1.0"},"reference-count":111,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T00:00:00Z","timestamp":1760400000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2014CCM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Human papillomavirus (HPV) represents the most common sexually transmitted infection worldwide and a major public health challenge. Nearly all sexually active individuals will acquire HPV during their lifetime, with the highest prevalence observed in adolescents and young adults shortly after sexual debut. More than 200 genotypes have been described, ranging from low-risk types, mainly responsible for benign lesions, to high-risk types, which are associated with cervical, anogenital, and head and neck cancers. While most infections are transient and spontaneously cleared by the immune system, persistent high-risk HPV can lead to precancerous lesions and malignant transformation, often in synergy with other sexually transmitted pathogens or in the context of microbiome imbalance. The introduction of vaccines and advanced screening technologies has substantially modified prevention strategies. Vaccination coverage remains heterogeneous, with persistent gaps particularly among males due to cultural, social, and educational barriers. Schools are increasingly recognized as strategic environments to promote awareness, sex education, and gender-neutral vaccination. Innovative approaches such as microbiome modulation, therapeutic vaccines, and liquid biopsy biomarkers are emerging as promising perspectives. This review aims to provide an updated overview of HPV epidemiology, clinical impact, prevention strategies, and future frontiers, with special attention to adolescents as a priority target group.<\/jats:p>","DOI":"10.3390\/pathogens14101043","type":"journal-article","created":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T10:37:14Z","timestamp":1760438234000},"page":"1043","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Human Papillomavirus: An Old New History"],"prefix":"10.3390","volume":"14","author":[{"given":"Nicole","family":"West","sequence":"first","affiliation":[{"name":"Department of Medical, Surgical, and Health Sciences, University of Trieste, 34127 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Boz","sequence":"additional","affiliation":[{"name":"Unit of Clinical, Treatment and Immunodeficiency Research, Department of Pediatrics, Institute for Maternal and Child Health, IRCCS \u201cBurlo Garofolo\u201d, 34137 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nunzia","family":"Zanotta","sequence":"additional","affiliation":[{"name":"Department of Advanced Translational Microbiology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3456-4395","authenticated-orcid":false,"given":"Carolina","family":"Cason","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical, and Health Sciences, University of Trieste, 34127 Trieste, Italy"},{"name":"Department of Advanced Translational Microbiology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2307-5537","authenticated-orcid":false,"given":"Giuseppina","family":"Campisciano","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical, and Health Sciences, University of Trieste, 34127 Trieste, Italy"},{"name":"Department of Advanced Translational Microbiology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5676-9535","authenticated-orcid":false,"given":"Alessandra","family":"Casuccio","sequence":"additional","affiliation":[{"name":"Section of Hygiene, PROMISE Department, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Gianfrilli","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa Maria Assunta","family":"Fasciana","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1407-7282","authenticated-orcid":false,"given":"Giuseppina","family":"Capra","sequence":"additional","affiliation":[{"name":"Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialities, University of Palermo, 90127 Palermo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Cristina","family":"Salfa","sequence":"additional","affiliation":[{"name":"AIDS Operational Centre, Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3850-627X","authenticated-orcid":false,"given":"Franz","family":"Sesti","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Suligoi","sequence":"additional","affiliation":[{"name":"AIDS Operational Centre, Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4071-0897","authenticated-orcid":false,"given":"Francesca","family":"Valent","sequence":"additional","affiliation":[{"name":"SOC Accreditation, Quality, and Clinical Risk, Friuli Centrale Healthcare University Trust, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5475-0021","authenticated-orcid":false,"given":"Laura","family":"Brunelli","sequence":"additional","affiliation":[{"name":"SOC Accreditation, Quality, and Clinical Risk, Friuli Centrale Healthcare University Trust, 33100 Udine, Italy"},{"name":"Department of Medicine, University of Udine, 33100 Udine, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manola","family":"Comar","sequence":"additional","affiliation":[{"name":"Department of Medical, Surgical, and Health Sciences, University of Trieste, 34127 Trieste, Italy"},{"name":"Department of Advanced Translational Microbiology, Institute for Maternal and Child Health-IRCCS Burlo Garofolo, 34137 Trieste, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1038\/nrc798","article-title":"Papillomaviruses and cancer: From basic studies to clinical application","volume":"2","year":"2002","journal-title":"Nat. Rev. Cancer"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/cac2.12629","article-title":"Advances in cervical cancer: Current insights and future directions","volume":"45","author":"Xu","year":"2025","journal-title":"Cancer Commun."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1128\/CMR.16.1.1-17.2003","article-title":"Human papillomavirus and cervical cancer","volume":"16","author":"Burd","year":"2003","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"107417","DOI":"10.1016\/j.oraloncology.2025.107417","article-title":"Current status of circulating tumor DNA and circulating cell alterations in HPV-associated head and neck cancer","volume":"167","author":"Araujo","year":"2025","journal-title":"Oral. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e2537","DOI":"10.1002\/rmv.2537","article-title":"Human papillomavirus infection: Epidemiology, biology, host interactions, cancer development, prevention, and therapeutics","volume":"34","author":"Wolf","year":"2024","journal-title":"Rev. Med. Virol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Jain, M., Yadav, D., Jarouliya, U., Chavda, V., Yadav, A.K., Chaurasia, B., and Song, M. (2023). Epidemiology, molecular pathogenesis, immuno-pathogenesis, immune escape mechanisms and vaccine evaluation for HPV-associated carcinogenesis. Pathogens, 12.","DOI":"10.3390\/pathogens12121380"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.virol.2010.02.002","article-title":"Classification of papillomaviruses (PVs) based on 189 PV types and proposal of taxonomic amendments","volume":"401","author":"Bernard","year":"2010","journal-title":"Virology"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"441","DOI":"10.1002\/path.4405","article-title":"Pathogenic role of the eight probably\/possibly carcinogenic HPV types 26, 53, 66, 67, 68, 70, 73 and 82 in cervical cancer","volume":"234","author":"Halec","year":"2014","journal-title":"J. Pathol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1158\/1055-9965.EPI-06-0846","article-title":"Incidence and duration of cervical human papillomavirus 6, 11, 16, and 18 infections in young women: An evaluation from multiple analytic perspectives","volume":"16","author":"Insinga","year":"2007","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Gazzetta, S., Valent, F., Sala, A., Driul, L., and Brunelli, L. (2024). Sexually transmitted infections and the HPV-related burden: Evolution of Italian epidemiology and policy. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1336250"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e1345","DOI":"10.1016\/S2214-109X(23)00305-4","article-title":"Global and regional estimates of genital human papillomavirus prevalence among men: A systematic review and meta-analysis","volume":"11","author":"Bruni","year":"2023","journal-title":"Lancet Glob. Health"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e29236","DOI":"10.1002\/jmv.29236","article-title":"HPV co-infections with other pathogens in cancer development: A comprehensive review","volume":"95","author":"Akbari","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_13","unstructured":"European Centre for Disease Prevention and Control (2025, August 28). Human Papillomavirus Infection: Recommended Vaccinations. Available online: https:\/\/vaccine-schedule.ecdc.europa.eu\/Scheduler\/ByDisease?SelectedDiseaseId=38&SelectedCountryIdByDisease=-1."},{"key":"ref_14","unstructured":"Italian Ministry of Health (2025, August 28). National Vaccination Prevention Plan 2016\u20132018. 2015. Available online: https:\/\/extranet.who.int\/countryplanningcycles\/sites\/default\/files\/planning_cycle_repository\/italy\/allegato1955037.pdf."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1835","DOI":"10.1080\/21645515.2019.1697596","article-title":"Adolescent HPV vaccination: Empowerment, equity and ethics","volume":"16","author":"Sundaram","year":"2020","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_16","unstructured":"Centers for Disease Control and Prevention (2025, August 28). Cancers Associated with Human Papillomavirus, Available online: https:\/\/www.cdc.gov\/united-states-cancer-statistics\/publications\/hpv-associated-cancers.html."},{"key":"ref_17","unstructured":"Bruni, L., Albero, G., Serrano, B., Mena, M., Collado, J.J., Mu\u00f1oz, J., G\u00f3mez, D., Bosch, F.X., and de Sanjos\u00e9, S. (2025, August 28). ICO\/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human papillomavirus and Related Diseases in Europe. Summary Report. 10 March 2023. Available online: www.hpvcentre.net."},{"key":"ref_18","unstructured":"International Agency for Research on Cancer Monographs on the Evaluation of Carcinogenic Risks to Humans (2012). Biological agents. IARC Monogr. Eval. Carcinog. Risks Hum., 100, 1\u2013363."},{"key":"ref_19","unstructured":"World Health Organization (2025, August 28). Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem; Seventy-Third World Health Assembly. 2020. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240014107."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1080\/14760584.2022.2129615","article-title":"Real-world impact and effectiveness of the quadrivalent HPV vaccine: An updated systematic literature review","volume":"21","author":"Wang","year":"2022","journal-title":"Expert. Rev. Vaccines"},{"key":"ref_21","first-page":"170","article-title":"Ten years of anti-HPV vaccinations: What do we know?","volume":"15","author":"Jach","year":"2016","journal-title":"Prz. Menopauzalny"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"101178","DOI":"10.1016\/j.lanepe.2024.101178","article-title":"Effectiveness of quadrivalent human papillomavirus vaccination against high-grade cervical lesions by age and doses: A population-based cohort study","volume":"49","author":"Wu","year":"2025","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1093\/jncimonographs\/lgae030","article-title":"Single-dose human papillomavirus vaccination: An update","volume":"2024","author":"Kreimer","year":"2024","journal-title":"J. Natl. Cancer Inst. Monogr."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2497608","DOI":"10.1080\/21645515.2025.2497608","article-title":"Impact of human papillomavirus vaccines in the reduction of infection, precursor lesions, and cervical cancer: A systematic literature review","volume":"21","author":"Harper","year":"2025","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Fappani, C., Bianchi, S., Panatto, D., Petrelli, F., Colzani, D., Scuri, S., Gori, M., Amendola, A., Grappasonni, I., and Tanzi, E. (2021). HPV type-specific prevalence a decade after the implementation of the vaccination program: Results from a pilot study. Vaccines, 9.","DOI":"10.3390\/vaccines9040336"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"E46","DOI":"10.5888\/pcd22.250127","article-title":"Eliminating cervical cancer: The impact of screening and human papilloma virus vaccination","volume":"22","author":"Nabi","year":"2025","journal-title":"Prev. Chronic Dis."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1006\/viro.1999.9868","article-title":"Establishment of the human papillomavirus type 16 (HPV-16) life cycle in an immortalized human foreskin keratinocyte cell line","volume":"262","author":"Flores","year":"1999","journal-title":"Virology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"6622","DOI":"10.1128\/JVI.74.14.6622-6631.2000","article-title":"The human papillomavirus type 16 E7 oncogene is required for the productive stage of the viral life cycle","volume":"74","author":"Flores","year":"2000","journal-title":"J. Virol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"8449","DOI":"10.1073\/pnas.96.15.8449","article-title":"Human papillomavirus type 31 oncoproteins e6 and e7 are required for the maintenance of episomes during the viral life cycle in normal human keratinocytes","volume":"96","author":"Thomas","year":"1999","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"319","DOI":"10.4143\/crt.2005.37.6.319","article-title":"The role of HPV e6 and e7 oncoproteins in HPV-associated cervical carcinogenesis","volume":"37","author":"Yim","year":"2005","journal-title":"Cancer Res. Treat."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1111\/j.1468-3083.2009.03242.x","article-title":"Psychological burden of anogenital warts","volume":"23","author":"Dediol","year":"2009","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.rmed.2017.03.030","article-title":"Recurrent respiratory papillomatosis: A state-of-the-art review","volume":"126","author":"Fortes","year":"2017","journal-title":"Respir. Med."},{"key":"ref_33","first-page":"S68","article-title":"Managing external genital warts: Practical aspects of treatment and prevention","volume":"17","author":"Bourcier","year":"2013","journal-title":"J. Cutan. Med. Surg."},{"key":"ref_34","first-page":"1","article-title":"Sexually transmitted diseases treatment guidelines, 2015","volume":"64","author":"Workowski","year":"2015","journal-title":"MMWR. Recomm. Rep."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"El Moussaoui, S., Fern\u00e1ndez-Campos, F., Alonso, C., Lim\u00f3n, D., Halbaut, L., Gardu\u00f1o-Ramirez, M.L., Calpena, A.C., and Mallandrich, M. (2021). Topical mucoadhesive alginate-based hydrogel loading ketorolac for pain management after pharmacotherapy, ablation, or surgical removal in condyloma acuminata. Gels, 7.","DOI":"10.3390\/gels7010008"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1016\/j.biopha.2018.06.149","article-title":"The human papillomavirus (HPV)-related cancer biology: An overview","volume":"106","author":"Araldi","year":"2018","journal-title":"Biomed. Pharmacother."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.meegid.2018.03.003","article-title":"Understanding the HPV integration and its progression to cervical cancer","volume":"61","year":"2018","journal-title":"Infect. Genet. Evol."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Ba\u00f1uelos-Villegas, E.G., P\u00e9rez-yP\u00e9rez, M.F., and Alvarez-Salas, L.M. (2021). Cervical cancer, papillomavirus, and miRNA dysfunction. Front. Mol. Biosci., 8.","DOI":"10.3389\/fmolb.2021.758337"},{"key":"ref_39","first-page":"CD008587","article-title":"Cytology versus HPV testing for cervical cancer screening in the general population","volume":"8","author":"Koliopoulos","year":"2017","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1055\/a-1198-5729","article-title":"Revised figo staging for cervical cancer\u2014A new role for mri","volume":"192","author":"Merz","year":"2020","journal-title":"Rofo"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1097\/00130404-200309000-00009","article-title":"Cervical cancer staging","volume":"9","author":"Pecorelli","year":"2003","journal-title":"Cancer J."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1097\/QAD.0000000000003004","article-title":"Prevalent human papillomavirus infection increases the risk of HIV acquisition in African women: Advancing the argument for human papillomavirus immunization","volume":"36","author":"Liu","year":"2022","journal-title":"AIDS"},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Gonz\u00e1lez, A., Cachay, E., Ocampo, A., and Poveda, E. (2022). Update on the epidemiological features and clinical implications of Human Papillomavirus Infection (HPV) and Human Immunodeficiency Virus (HIV) coinfection. Microorganisms, 10.","DOI":"10.3390\/microorganisms10051047"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"105587","DOI":"10.1016\/j.micpath.2022.105587","article-title":"A literature review on correlation between HPV coinfection with C. Trachomatis and cervical neoplasia-coinfection mediated cellular transformation","volume":"168","author":"Kumari","year":"2022","journal-title":"Microb. Pathog."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2319962","DOI":"10.1080\/21505594.2024.2319962","article-title":"And HPV16 coinfection may contribute to the development of cervical cancer","volume":"15","author":"Zou","year":"2024","journal-title":"Virulence"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Sausen, D.G., Shechter, O., Gallo, E.S., Dahari, H., and Borenstein, R. (2023). Herpes simplex virus, human papillomavirus, and cervical cancer: Overview, relationship, and treatment implications. Cancers, 15.","DOI":"10.3390\/cancers15143692"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"e650","DOI":"10.1093\/infdis\/jiaf033","article-title":"Association between herpes simplex virus type 2 and high-risk human papillomavirus infections: A population study of the national health and nutrition examination survey, 2009\u20132016","volume":"231","author":"Liu","year":"2025","journal-title":"J. Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Ray, A. (2025). Human papillomavirus and other relevant issues in cervical cancer pathogenesis. Int. J. Mol. Sci., 26.","DOI":"10.3390\/ijms26125549"},{"key":"ref_49","first-page":"361","article-title":"Transformation of primary hamster embryo fibroblasts by type 2 simplex virus: Evidence for a \u201cHit and run\u201d Mechanism","volume":"57","author":"Skinner","year":"1976","journal-title":"Br. J. Exp. Pathol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1002\/ijgo.14763","article-title":"Trichomonas vaginalis infection is associated with increased risk of cervical carcinogenesis: A systematic review and meta-analysis of 470,000 patients","volume":"163","author":"Hamar","year":"2023","journal-title":"Int. J. Gynaecol. Obstet."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.gocm.2023.10.002","article-title":"Trichomonas vaginalis and human papillomavirus: Association with the microbiota and burden on the cervix","volume":"3","author":"Osafo","year":"2023","journal-title":"Gynecol. Obstet. Clin. Med."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Augustin, J.G., Lepine, C., Morini, A., Brunet, A., Veyer, D., Brochard, C., Mirghani, H., P\u00e9r\u00e9, H., and Badoual, C. (2020). HPV detection in head and neck squamous cell carcinomas: What is the issue?. Front. Oncol., 10.","DOI":"10.3389\/fonc.2020.01751"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1038\/s41571-022-00603-7","article-title":"HPV-associated oropharyngeal cancer: Epidemiology, molecular biology and clinical management","volume":"19","author":"Lechner","year":"2022","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1186\/s12967-025-06470-x","article-title":"Human papilloma virus (HPV) mediated cancers: An insightful update","volume":"23","author":"Baba","year":"2025","journal-title":"J. Transl. Med."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1038\/s41571-024-00904-z","article-title":"Epidemiology of HPV-associated cancers past, present and future: Towards prevention and elimination","volume":"21","author":"Franco","year":"2024","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Silva, L.L.D., Teles, A.M., Santos, J.M.O., Souza de Andrade, M., Medeiros, R., Faustino-Rocha, A.I., Oliveira, P.A., Dos Santos, A.P.A., Ferreira Lopes, F., and Braz, G. (2023). Malignancy associated with low-risk hpv6 and hpv11: A systematic review and implications for cancer prevention. Cancers, 15.","DOI":"10.3390\/cancers15164068"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1097\/GRF.0b013e31825caa36","article-title":"HPV: Diagnosis, prevention, and treatment","volume":"55","author":"Hathaway","year":"2012","journal-title":"Clin. Obstet. Gynecol."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"e29409","DOI":"10.1002\/jmv.29409","article-title":"Advanced technologies towards improved HPV diagnostics","volume":"96","author":"Bartosik","year":"2024","journal-title":"J. Med. Virol."},{"key":"ref_59","first-page":"321","article-title":"Cervical cancer screening for individuals at average risk: 2020 guideline update from the american cancer society","volume":"70","author":"Fontham","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"e1115","DOI":"10.1016\/S2214-109X(22)00241-8","article-title":"Cervical cancer screening programmes and age-specific coverage estimates for 202 countries and territories worldwide: A review and synthetic analysis","volume":"10","author":"Bruni","year":"2022","journal-title":"Lancet Glob. Health"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1428","DOI":"10.1039\/D4AY01921K","article-title":"Advances in human papillomavirus detection for cervical cancer screening and diagnosis: Challenges of conventional methods and opportunities for emergent tools","volume":"17","author":"Fashedemi","year":"2025","journal-title":"Anal. Methods"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s12985-024-02601-w","article-title":"A new approach for detecting HPV DNA in cervical swabs: Comparison of nucleic acid extraction with direct PCR","volume":"22","author":"Kaygusuz","year":"2025","journal-title":"Virol. J."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"106900","DOI":"10.1016\/j.ypmed.2021.106900","article-title":"Worldwide use of HPV self-sampling for cervical cancer screening","volume":"154","author":"Serrano","year":"2022","journal-title":"Prev. Med."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"6333","DOI":"10.2147\/IJN.S524518","article-title":"Recent advances in HPV detection: From traditional methods to nanotechnology and the application of quantum dots","volume":"20","author":"He","year":"2025","journal-title":"Int. J. Nanomed."},{"key":"ref_65","doi-asserted-by":"crossref","unstructured":"Daponte, N., Valasoulis, G., Michail, G., Magaliou, I., Daponte, A.I., Garas, A., Grivea, I., Bogdanos, D.P., and Daponte, A. (2023). HPV-based self-sampling in cervical cancer screening: An updated review of the current evidence in the literature. Cancers, 15.","DOI":"10.3390\/cancers15061669"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"W\u0142oszek, E., Krupa, K., Skrok, E., Budzik, M.P., Depta\u0142a, A., and Badowska-Kozakiewicz, A. (2025). HPV and cervical cancer-biology, prevention, and treatment updates. Curr. Oncol., 32.","DOI":"10.3390\/curroncol32030122"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1186\/s13148-023-01537-2","article-title":"DNA methylation as a triage marker for colposcopy referral in HPV-based cervical cancer screening: A systematic review and meta-analysis","volume":"15","author":"Salta","year":"2023","journal-title":"Clin. Epigenetics"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Wang, M., Ma, Y., Zhang, N., Li, L., Fu, Y., and Zhai, Q. (2025). Methylation testing versus cervical cytology for triage of HPV-positive women: A comparative study. Diagn. Microbiol. Infect. Dis., 113.","DOI":"10.1016\/j.diagmicrobio.2025.116917"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"102678","DOI":"10.1016\/j.pmedr.2024.102678","article-title":"DNA methylation as a triage tool for cervical cancer screening\u2014A meeting report","volume":"41","author":"Burdier","year":"2024","journal-title":"Prev. Med. Rep."},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"107262","DOI":"10.1016\/j.oraloncology.2025.107262","article-title":"Circulating tumor DNA in human papillomavirus-associated oropharyngeal cancer management: A systematic review","volume":"164","author":"Chennareddy","year":"2025","journal-title":"Oral. Oncol."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"e0769","DOI":"10.1097\/PPO.0000000000000769","article-title":"The role of circulating tumor DNA (ctDNA) in the treatment of human papilloma virus-positive (hpv+) oropharyngeal squamous cell carcinoma","volume":"31","author":"Qian","year":"2025","journal-title":"Cancer J."},{"key":"ref_72","doi-asserted-by":"crossref","unstructured":"Tatsumi, M., Tanaka, H., Takenaka, Y., Suzuki, M., Fukusumi, T., Eguchi, H., Watabe, T., Kato, H., Yachida, S., and Inohara, H. (2024). Association of circulating tumor HPV16DNA levels and quantitative pet parameters in patients with HPV-positive head and neck squamous cell carcinoma. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-53894-4"},{"key":"ref_73","first-page":"e47685","article-title":"A comprehensive review of treatment approaches for cutaneous and genital warts","volume":"15","author":"Kore","year":"2023","journal-title":"Cureus"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"3001","DOI":"10.1016\/j.vaccine.2007.01.013","article-title":"Developing an HPV vaccine to prevent cervical cancer and genital warts","volume":"25","author":"Bryan","year":"2007","journal-title":"Vaccine"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1111\/cas.12106","article-title":"Efficacy of quadrivalent human papillomavirus (types 6, 11, 16 and 18) vaccine (gardasil) in japanese women aged 18-26 years","volume":"104","author":"Yoshikawa","year":"2013","journal-title":"Cancer Sci."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1016\/S0140-6736(07)60946-5","article-title":"Efficacy of a prophylactic adjuvanted bivalent L1 virus-like-particle vaccine against infection with human papillomavirus types 16 and 18 in young women: An interim analysis of a phase III double-blind, randomised controlled trial","volume":"369","author":"Paavonen","year":"2007","journal-title":"Lancet"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/S0140-6736(09)61248-4","article-title":"Efficacy of human papillomavirus (HPV)-16\/18 as04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (patricia): Final analysis of a double-blind, randomised study in young women","volume":"374","author":"Paavonen","year":"2009","journal-title":"Lancet"},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/S1470-2045(11)70286-8","article-title":"Overall efficacy of HPV-16\/18 as04-adjuvanted vaccine against grade 3 or greater cervical intraepithelial neoplasia: 4-year end-of-study analysis of the randomised, double-blind patricia trial","volume":"13","author":"Lehtinen","year":"2012","journal-title":"Lancet Oncol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"5087","DOI":"10.1016\/j.vaccine.2014.06.038","article-title":"Efficacy of the HPV-16\/18 vaccine: Final according to protocol results from the blinded phase of the randomized costa rica HPV-16\/18 vaccine trial","volume":"32","author":"Hildesheim","year":"2014","journal-title":"Vaccine"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.canlet.2019.11.039","article-title":"Human papillomavirus vaccine against cervical cancer: Opportunity and challenge","volume":"471","author":"Wang","year":"2020","journal-title":"Cancer Lett."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"827","DOI":"10.1016\/j.cmi.2015.05.001","article-title":"From the monovalent to the nine-valent HPV vaccine","volume":"21","author":"Pils","year":"2015","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"469","DOI":"10.4161\/hv.26846","article-title":"Safety of an escherichia coli-expressed bivalent human papillomavirus (types 16 and 18) L1 virus-like particle vaccine: An open-label phase I clinical trial","volume":"10","author":"Hu","year":"2014","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_83","unstructured":"World Health Organization (2022, April 24). HPV Vaccine Global Market Study April 2022. Available online: https:\/\/www.who.int\/publications\/m\/item\/who-hpv-vaccine-global-market-study-april-2022."},{"key":"ref_84","unstructured":"World Health Organization (2025, August 27). Human Papillomavirus Vaccines: WHO Position Paper, 2022 Update. Available online: https:\/\/www.who.int\/publications\/i\/item\/who-wer9750-645-672."},{"key":"ref_85","unstructured":"Simone, B., and Guidance, E. (2025, August 28). Introduction of HPV Vaccines in European Union Countries\u2014An Update. 2012. Available online: https:\/\/www.ecdc.europa.eu\/sites\/default\/files\/media\/en\/publications\/Publications\/20120905_GUI_HPV_vaccine_update.pdf."},{"key":"ref_86","unstructured":"Phillips, M., Morais, E., Kothari, S., Tantri, A., Parellada, C.I., Cashat, M., Walia, A., Shrestha, A., and Perez Amaya, G.E. (2018, January 2\u20136). Evolution of gender-neutral HPV vaccination in national immunization programs around the world. Proceedings of the 32nd International Papillomavirus Conference, Sydney, Australia."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1086\/597309","article-title":"The impact of quadrivalent human papillomavirus (HPV; types 6, 11, 16, and 18) L1 virus-like particle vaccine on infection and disease due to oncogenic nonvaccine HPV types in sexually active women aged 16\u201326 years","volume":"199","author":"Wheeler","year":"2009","journal-title":"J. Infect. Dis."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"1680","DOI":"10.1016\/j.vaccine.2021.02.022","article-title":"Sex difference in the immunogenicity of the quadrivalent human papilloma virus vaccine: Systematic review and meta-analysis","volume":"39","author":"Aldakak","year":"2021","journal-title":"Vaccine"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"106399","DOI":"10.1016\/j.ypmed.2020.106399","article-title":"HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010\u20132019","volume":"144","author":"Bruni","year":"2021","journal-title":"Prev. Med."},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Brunelli, L., Valent, F., Comar, M., Suligoi, B., Salfa, M.C., Gianfrilli, D., Sesti, F., Restivo, V., Casuccio, A., and Group, E.S.C. (2024). Study protocol for a pre\/post study on knowledge, attitudes and behaviors regarding stis and in particular HPV among Italian adolescents, teachers, and parents in secondary schools. Front. Public Health, 12.","DOI":"10.3389\/fpubh.2024.1414631"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1136\/ijgc-2022-004213","article-title":"The european society of gynaecological oncology (esgo), the international society for the study of vulvovaginal disease (issvd), the european college for the study of vulval disease (ecsvd), and the european federation for colposcopy (efc) consensus statement on the management of vaginal intraepithelial neoplasia","volume":"33","author":"Kesic","year":"2023","journal-title":"Int. J. Gynecol. Cancer"},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"4190","DOI":"10.1016\/j.vaccine.2021.05.051","article-title":"School-based HPV vaccination positively impacts parents\u2019 attitudes toward adolescent vaccination","volume":"39","author":"Davies","year":"2021","journal-title":"Vaccine"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1016\/j.pedhc.2024.07.006","article-title":"Adolescent self-consent for the HPV vaccine and the effects on vaccine rates","volume":"38","author":"Thompson","year":"2024","journal-title":"J. Pediatr. Health Care"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"101570","DOI":"10.1016\/j.pmedr.2021.101570","article-title":"Beliefs about HPV vaccination and awareness of vaccination status: Gender differences among Northern Italy adolescents","volume":"24","author":"Brunelli","year":"2021","journal-title":"Prev. Med. Rep."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"1537","DOI":"10.1002\/ijc.34839","article-title":"Scientific approaches toward improving cervical cancer elimination strategies","volume":"154","author":"Lehtinen","year":"2024","journal-title":"Int. J. Cancer"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1099\/jmm.0.000245","article-title":"HPV genotypes distribution in chlamydia trachomatis co-infection in a large cohort of women from north-east Italy","volume":"65","author":"Seraceni","year":"2016","journal-title":"J. Med. Microbiol."},{"key":"ref_97","doi-asserted-by":"crossref","unstructured":"Zhou, Z.W., Long, H.Z., Cheng, Y., Luo, H.Y., Wen, D.D., and Gao, L.C. (2021). From microbiome to inflammation: The key drivers of cervical cancer. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.767931"},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Huang, R., Liu, Z., Sun, T., and Zhu, L. (2024). Cervicovaginal microbiome, high-risk HPV infection and cervical cancer: Mechanisms and therapeutic potential. Microbiol. Res., 287.","DOI":"10.1016\/j.micres.2024.127857"},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"Ntuli, L., Mtshali, A., Mzobe, G., Liebenberg, L.J., and Ngcapu, S. (2022). Role of immunity and vaginal microbiome in clearance and persistence of human papillomavirus infection. Front. Cell Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.927131"},{"key":"ref_100","doi-asserted-by":"crossref","unstructured":"Campisciano, G., Iebba, V., Zito, G., Luppi, S., Martinelli, M., Fischer, L., De Seta, F., Basile, G., Ricci, G., and Comar, M. (2020). Lactobacillus iners and gasseri, Prevotella bivia and HPV Belong to the Microbiological Signature Negatively Affecting Human Reproduction. Microorganisms. Microorganisms, 9.","DOI":"10.3390\/microorganisms9010039"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"153234","DOI":"10.1016\/j.prp.2020.153234","article-title":"Gardnerella vaginalis and trichomonas vaginalis infections and the risk of persistence or progression of low-grade cervical intraepithelial neoplasia","volume":"216","author":"Raffone","year":"2020","journal-title":"Pathol. Res. Pr. Pract."},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Zhang, Z., Ma, Q., Zhang, L., Ma, L., Wang, D., Yang, Y., Jia, P., Wu, Y., and Wang, F. (2024). Human papillomavirus and cervical cancer in the microbial world: Exploring the vaginal microecology. Front. Cell Infect. Microbiol., 14.","DOI":"10.3389\/fcimb.2024.1325500"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"S49","DOI":"10.1093\/advances\/nmy063","article-title":"Mechanisms of action of probiotics","volume":"10","author":"Gil","year":"2019","journal-title":"Adv. Nutr."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"659","DOI":"10.2147\/IDR.S232982","article-title":"The battle of probiotics and their derivatives against biofilms","volume":"13","author":"Barzegari","year":"2020","journal-title":"Infect. Drug Resist."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1080\/09540105.2019.1579785","article-title":"Two strains of probiotic Lactobacillus enhance immune response and promote naive T cell polarization to Th1","volume":"30","author":"Ren","year":"2019","journal-title":"Food Agric. Immunol."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1191","DOI":"10.1007\/s00018-020-03652-2","article-title":"Twenty years of research on HPV vaccines based on genetically modified lactic acid bacteria: An overview on the gut-vagina axis","volume":"78","author":"Keyvani","year":"2021","journal-title":"Cell Mol. Life Sci."},{"key":"ref_107","doi-asserted-by":"crossref","unstructured":"Mohseni, A.H., Taghinezhad-S, S., Keyvani, H., and Razavilar, V. (2019). Extracellular overproduction of e7 oncoprotein of iranian human papillomavirus type 16 by genetically engineered lactococcus lactis. BMC Biotechnol., 19.","DOI":"10.1186\/s12896-019-0499-5"},{"key":"ref_108","first-page":"40","article-title":"Phase 1 safety and immunogenicity trial of recombinant","volume":"15","author":"Mohseni","year":"2019","journal-title":"Mol. Ther. Methods Clin. Dev."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"3456","DOI":"10.1016\/j.apsb.2022.07.002","article-title":"Mucosal vaccine delivery: A focus on the breakthrough of specific barriers","volume":"12","author":"Huang","year":"2022","journal-title":"Acta Pharm. Sin. B"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"e88","DOI":"10.3802\/jgo.2019.30.e88","article-title":"A phase 1\/2a, dose-escalation, safety and preliminary efficacy study of oral therapeutic vaccine in subjects with cervical intraepithelial neoplasia 3","volume":"30","author":"Park","year":"2019","journal-title":"J. Gynecol. Oncol."},{"key":"ref_111","doi-asserted-by":"crossref","unstructured":"Brunelli, L., Valent, F., Comar, M., Suligoi, B., Salfa, M.C., Gianfrilli, D., Sesti, F., Capra, G., Casuccio, A., and De Luca, E. (2025). Knowledge about HPV and the HPV vaccine: Observational study on a convenience sample of adolescents from select schools in three regions in Italy. Vaccines, 13.","DOI":"10.3390\/vaccines13030227"}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/10\/1043\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T10:52:32Z","timestamp":1760439152000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/10\/1043"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,14]]},"references-count":111,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["pathogens14101043"],"URL":"https:\/\/doi.org\/10.3390\/pathogens14101043","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,14]]}}}