Besides exposure to HPV, what are other risk factors for cervical cancer?
Dr. Lowy: The biggest clearly identified risk factor is immuno-suppression. Survivors of renal transplant, AIDS patients, and people with impaired cell-mediated immunity are at high risk of persistent HPV infection, high-grade dysplasia, and cervical cancer. Beyond that, there is epidemiologic evidence implicating smoking. It makes some sense because there are carcinogens in cigarette smoke that can be found in the vaginal tract. You published a paper in February 2001 in the Journal of the National Cancer Institute showing proof-of-principle for your HPV vaccine. Could you briefly describe how the vaccine was made and the results? Dr. Lowy: The vaccine we used consists of several copies of an HPV-16 protein, L1. By way of some background, our breakthrough observation in 1992 (Proc Natl Acad. Sci USA 1992;89:12180-12184) showed that multiple copies of the L1 protein alone can join together to form a 3- dimensional structure that resembles the virus – it has the shell of the virus but wi
