El cáncer cervicouterino (CaCU) se caracteriza por el establecimiento de una infección persistente causada por el virus del papiloma humano (VPH). Pero ¿por qué el sistema inmune ignora o al menos muestra fallas para detectar la infección por VPH? Esta ha sido una pregunta central que ha permanecido durante años y que aún sigue sin contestarse en su totalidad, aunque en la actualidad ya se sabe que el VPH emplea una variedad de estrategias para evadir o subvertir la vigilancia inmune, lo cual será crítico para definir si persiste o no la infección viral y, por consiguiente, el riesgo de progresión a cáncer. Por lo mismo, en esta revisión se abordarán algunos de los mecanismos más importantes que el VPH utiliza para escapar al ataque inicial impuesto por la respuesta inmune innata y que le permiten establecerse como una infección persistente, lo cual facilita la progresión de las lesiones cervicales hasta que se convierten en cáncer. Indudablemente, el entendimiento del equilibrio entre factores virales e inmunológicos proporcionará información determinante que deberá tomarse en cuenta en la planeación estratégica de vacunas profilácticas y terapéuticas contra el CaCU asociado a la infección por VPH.
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