HPV: a unique study uncovers the mysteries of the infection in nearly 200 women recruited at the Montpellier University Hospital

HPVs are a very large family of viruses “present in almost all women who have sexual relations”, explains Samuel Alizon. CREATIVE COMMONS

For the first time, a team of biologists, under the responsibility of Samuel Alizon, research director at the CNRS, has studied the evolution of human papillomavirus infection. HPVs are known to be involved in cervical cancer, which affects 3,000 women in France each year.

Research on papillomaviruses, HPVs known to the general public as part of vaccination campaigns for adolescents against the risk of cervical cancer, has just taken a giant step forward thanks to a study conducted in Montpellier.

Unprecedented at the international level, it was published this Tuesday, January 21, in the leading American scientific journal Plos Biology.

Samuel Alizon is looking for funding to continue the study on his cohort. PATRICK_IMBERT/COLLEGE DE FRANCE

Led by Samuel Alizon, CNRS research director who left Montpellier two years ago to join the Interdisciplinary Center for Biology Research (CIRB) at the Collège de France in Paris, it is based on the unprecedented monitoring of 189 women aged 18 to 25, recruited at the Montpellier University Hospital, for four years.

None of them have cancer, which is not the aim of the study.

Women seen every two months

“We know about papillomaviruses because they cause cancer in a minority of infected women,” Samuel Alizon nevertheless points out.

His team, however, collected an impressive amount of “biological samples obtained using cutting-edge techniques in molecular biology and immunology” from participants, seen every two months, over the course of 900 visits scheduled between 2016 and 2020, to “understand the processes that occur during an infection, from start to finish. We realized that we didn't know much”.

The infectious episode is generally asymptomatic and the disease is benign, it heals “in 9 cases out of 10 in less than two years”. In one case out of 100, it persists.

What do the samples say ? “In this age group, one in four women is infected with HPV”, “including vaccinated women”. But the vaccine worked well: in the latter, “we do not find the most dangerous viruses, implicated in cancers, HPV16 and HPV18” , underlines Samuel Alizon.

Avoid worrying unnecessarily

In infected women: “The quantity of virus increases exponentially in a few weeks, then reaches a plateau that lasts 18 months on average, before gradually decreasing. We are in an intermediate case between acute infection and chronic infection. This is unusual. The first lesson of our research is that there is no point in retesting too quickly in the event of infection, and in worrying unnecessarily”, reports the scientist.

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The study also shows that there are two scenarios of immune responses: one is “innate”, the other “adaptive”. Each has its own specific biological markers. The former were present in women who controlled the infection most quickly. Both types of markers are present when the infection persists over time, suggesting that the body has reacted in two stages, explains Samuel Alizon.

Why ? “We are opening up a lot of avenues. Our study can help research into therapies, which is very active in immunotherapy in particular, and optimize vaccine protection”, explains the scientist.

A virus in a state of latency ?

By understanding the mechanisms of infection, the team wants to pave the way for new therapies, and, perhaps later, for cancer treatment: “By understanding the phenomenon of spontaneous cures, we have the keys to curing chronic infections.”

To go further, Samuel Alizon is ready to relaunch the search for European credits, which kicked off this study ten years ago.

“It's a long time, but we're working on a long time ourselves,” recalls Samuel Alizon, who hopes to unravel another mystery: “Will women who develop cancer have been reinfected, or will they experience the consequences of a past infection, which was thought to be cured, with a virus remaining in a latent state in the body ?”

Health Insurance, which is organizing a cervical cancer prevention week from January 23, reminds us that “It takes between 10 and 20 years between HPV infection and the appearance of precancerous or cancerous lesions.”

The 19th European Cervical Cancer Prevention Week

“Every year, more than 3,000 women in France are diagnosed with cervical cancer, and nearly 1,100 die from it. Yet, 90% of these cancers could be avoided thanks to two effective and complementary preventive measures: regular screening and vaccination against the human papillomavirus”, warn the Occitanie regional health agency, the Health Insurance and the Occitanie Regional Cancer Screening Coordination Center (CRCDC), on the occasion of the 19th European Cervical Cancer Prevention Week, from January 23 to 29.

The health authorities are calling on women aged 25 to 65 to get screened by their general practitioner, a gynecologist, a midwife or at a health examination center of the Health Insurance disease.

In 2024, 60,000 letters had been sent in the region as part of organized screening. The analysis of the sample is then covered 100%, without advance payment, by Health Insurance. In Occitanie, participation in screening is 61.8% (59.5% in France), very far from the objectives of an effective campaign defined at the European level: 70% participation.

Vaccination of adolescents, the only effective means of preventing cancer, is also insufficient: in 2023, 43.8% of 16-year-old girls and 15.2% of boys.

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