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Vertical transmission of HPV rare
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NEW YORK (Reuters Health) - By comparing the prevalence and type of human papillomavirus (HPV) in parents and their newborns, investigators have shown that the risk of vertical transmission is quite low, despite a relatively high positivity rate in the maternal cervix.
Because HPV infection is associated with genital and oral cancers, anti-HPV vaccines are currently in development as a means of reducing oncogenesis (see Reuters Health reports, January 16 and August 12, 2003). Epidemiology of the virus "should be resolved to determine at what age or time in one's sexual experience it is best to vaccinate against HPV," Dr. Elaine M. Smith and colleagues note in their report in the January issue of Sexually Transmitted Diseases.
The authors collected cervical swabs from 574 women late in gestation and immediately before delivery. The mothers and 68 fathers also provided oral specimens. Infants' mouths and genitals were swabbed at a mean of 65 hours after birth.
HPV infection was documented in the cervix of 29% of the woman and in the oral cavity in 2.4%. Oral infections were detected in 6% of fathers, but none of these men had an infant who was HPV-positive. The detection rate in newborns was 1.6%. The HPV detection rate was similar in the 500 babies born vaginally and the 74 delivered by cesarean section.
Only six mother/infant pairs were infected, and only one pair was concordant according to results of polymerase chain reaction and DNA sequencing, yielding a type-specific concordance rate of 0.2%. The three HPV-positive children retested at follow-up 3 months later were all found to be negative, suggesting that the initial presence have been be due to contamination rather than true infection.
In an editorial response, Dr. Laura A. Koutsky and Rachel L. Winer, with the University of Washington in Seattle, suggest that the source of newborn HPV could be equipment used during or after delivery or through casual digital contact with hospital staff or visitors.
"Parents should be reassured that while HPV is commonly detected in pregnant women, detection of HPV in newborns is rare and does not appear to be associated with persistent infection," they write.
Sex Transm Dis 2004;31:57-64.
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