Review: current knowledge on the role of HPV antibodies after natural infection and vaccination: implications for monitoring an HPV vaccination programme

In 2006/2007, two vaccines were licensed against two of the most common HPV types that cause about 70% of cervical cancers. Clinical trials show that vaccinated individuals develop high levels of neutralizing antibodies. Although these data suggest that serum antibodies are the mode of action against HPV infection, it is uncertain whether immune responses generated by vaccination are similar to those induced by a natural infection. In this review, the current knowledge of humoral immune responses after natural infection and vaccination is described. Serosurveillance can be used as a monitoring tool to study vaccine uptake, the impact of HPV16/18 vaccination on other HPV types, dynamics of HPV infection and herd-immunity. In addition, factors that contribute to a higher seroresponse after a natural infection, which are summarized in this article (a persistent DNA infection, increased viral load, immunosuppression and high sexual risk behavior), can help to interpret these indirect effects better.