A variety of serological assays to detect antibodies to genital-type HPVs have been developed. Bacterially expressed fusion proteins, synthetic peptides and HPV 11 virus propagated in a xenograft system have been the most commonly used antigen targets in either Western blot assays or ELISAs. HPV antibodies have been readily detected and most studies suggest that they are type-specific. Primarily, antibodies appear to be directed against the capsid antigens. The presence or titre of antibodies to the HPV 16 E7 protein is strongly associated with cervical cancer in approximately 25% of cases. The significance of antibodies to other HPV antigens, or of antibodies which recognize conformational epitopes is less clear. Attempts to validate the sensitivity and specificity of serological assays are extremely preliminary, and are complicated by a lack of understanding of the natural history of papillomavirus infections.
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