Human Papillomavirus Infection In Children Research Articles

Oral Human Papillomavirus Infection in Children during the First 6 Years of Life, Finland.

Human papillomavirus (HPV) infections are found in children, but transmission modes and outcomes are incompletely understood. We evaluated oral samples from 331 children in Finland who participated in the Finnish Family HPV Study from birth during 9 follow-up visits (mean time 51.9 months). We tested samples for 24 HPV genotypes. Oral HPV prevalence for children varied from 8.7% (at a 36-month visit) to 22.8% (at birth), and 18 HPV genotypes were identified. HPV16 was the most prevalent type to persist, followed by HPV18, HPV33, and HPV6. Persistent, oral, high-risk HPV infection for children was associated with oral HPV carriage of the mother at birth and seroconversion of the mother to high-risk HPV during follow-up (odds ratio 1.60–1.92, 95% CI 1.02–2.74). Children acquire their first oral HPV infection at an early age. The HPV status of the mother has a major impact on the outcome of oral HPV persistence for her offspring.

Transmission of carcinogenic human papillomavirus types from mother to child

Currently, human papillomavirus (HPV) research focuses on HPV infection in adults and sexual transmission. Data on HPV infection in children are slowly becoming available. It is a matter of debate whether mother-to-child transmission of HPV is an important infection route and whether children born to HPV-positive mothers are at a higher risk of HPV infection compared with children born to HPV-negative mothers. The objective of this meta-analysis is to summarize the published literature on the extent to which genital HPV infection is vertically transmitted from mother to child. Medline, Web of Science, and CINAHL were searched for eligible reports published before January 2011. Differences in the risk of HPV infection between newborns from HPV-positive and HPV-negative mothers were pooled using a random-effects model. Twenty eligible studies, including 3128 women/children pairs, fulfilled the selection criteria. High heterogeneity could be found (I=96%). The overall estimated risk difference was 33% (95% confidence interval: 22-44%). On restricting to high-risk HPV-positive mothers only (n=4; women=231), the difference in risk was 45% (95% confidence interval: 33-56%). The heterogeneity was found to be low (I=15%). This meta-analysis indicates a significantly higher risk for children born to HPV-positive mothers to become HPV positive themselves. Plausible explanations include vertical transmission of HPV during pregnancy and/or birth or a higher infection rate during early nursing from mother to child. More research is required to gain an insight into the precise mode of transmission and the clinical effects of infection on the child.

Screening and detection of human papillomavirus (HPV) high-risk strains HPV16 and HPV18 in saliva samples from subjects under 18 years old in Nevada: a pilot study

BackgroundHuman papillomaviruses (HPV) are oncogenic and mainly associated with cervical cancers. Recent evidence has demonstrated HPV infection in other tissues, including oral epithelia and mucosa. Although a recent pilot study provided new information about oral HPV status in healthy adults from Nevada, no information was obtained about oral HPV prevalence among children or teenagers, therefore, the goal of this study is to provide more detailed information about oral prevalence of high-risk HPV among children and teenagers in Nevada.MethodsThis retrospective study utilized previously collected saliva samples, obtained from pediatric dental clinic patients (aged 2 – 11) and local school district teenagers (aged 12-17) for high-risk HPV screening (n=118) using qPCR for quantification and confirmation of analytical sensitivity and specificity.ResultsA small subset of saliva samples were found to harbor high-risk HPV16 (n=2) and HPV18 (n=1), representing a 2.5% of the total. All three were obtained from teenage males, and two of these three samples were from White participants.ConclusionsAlthough this retrospective study could not provide correlations with behavioral or socioeconomic data, this project successfully screened more than one hundred saliva samples for high-risk HPV, confirming both HPV16 and HPV18 strains were present in a small subset. With increasing evidence of oral HPV infection in children, this study provides critical information of significant value to other dental, medical, oral and public health professionals who seek to further an understanding of oral health and disease risk in pediatric populations.

Head and neck cancer: effective prevention in youth and predictive diagnostics for personalised treatment strategies according to biological differences

This article focuses on squamous cell carcinomas of the larynx, pharynx and oral cavity which count nearly 90% of the head and neck squamous cell carcinomas (HNSCC). Individual susceptibility depends on an individually given genetic background and/or acquired conditions or factors elevating the risk of HNSCC including smoking, alcohol abuse, and improper oral hygiene. A key issue in HNSCC pathogenesis is their development within large preneoplastic fields of mucosal epithelium made up of genetically altered cells that are clonally related to the carcinoma. Other individual differences in development of HNSCC comprise infection with pathogenic microbes and oncogenic human papillomavirus (HPV) subtypes like HPV 16 (a strong risk factor mainly for oropharyngeal cancer). Interestingly, the presence of HPV 16 also goes in line with better outcome after therapy. Vaccination against HPV infection in children plays an increasing role in prevention strategies and probably also reduces the oncogenic risk for HNSCC.

Venereal Warts in Children

1. Kelly A. Sinclair, MD* 2. Charles R. Woods, MD, MS† 3. Sara H. Sinal, MD§ 1. *Emergency Medical Services, The Children's Mercy Hospital and Clinics, Kansas City, MO. 2. †Department of Pediatrics, University of Louisville School of Medicine, Louisville, KY. 3. §Department of Pediatrics, Wake Forest University Health Sciences, Winston-Salem, NC. After completing this article, readers should be able to: 1. Describe the natural history and epidemiology of anogenital human papillomavirus infection. 2. Discuss diagnosis and treatment options for children who have anogenital warts. 3. Recognize when anogenital warts are suggestive of child sexual abuse and what steps are needed to manage this clinical problem. More than 24 million cases of human papillomavirus (HPV) infection occur in adults in the United States, with an estimated 1 million new cases developing each year. The number of outpatient visits for adults who have venereal warts (condyloma acuminata) increased fivefold from 1966 to 1981. (1) HPV infections in children may present as common skin warts, anogenital warts (AGW), oral and laryngeal papillomas, and subclinical infections. The increased incidence of AGW in children has paralleled that of adults. AGW in children present a unique diagnostic challenge: Is the HPV infection a result of child sexual abuse (CSA), which requires reporting to Child Protective Services (CPS), or acquired through an otherwise innocuous mechanism? Practitioners must balance “missing” a case of CSA if they do not report to CPS against reporting to CPS and having parents or other caregivers potentially suffer false accusation and its potential ramifications, which may include losing custody of children. In the past, simply identifying AGW in a young child was considered indicative of CSA by some experts. However, there is no defined national standard beyond the limited guidance provided in the 2005 American Academy of Pediatrics (AAP) Policy Statement, which states that AGW are suspicious for CSA if not perinatally acquired and the …

Current concepts on human papillomavirus infections in children

Current evidence is strong enough to conclude that human papillomavirus (HPV) can be transmitted both sexually and non-sexually. The debate on HPV infections in children still continues but it is more focused on HPV prevalence than on transmission modes. HPV DNA detection in amniotic fluid, foetal membranes, cord blood and placental trophoblastic cells all suggest HPV infection in utero, i.e. prenatal transmission. Based on recent meta-analysis, vertical transmission occurs in approximately 20% of cases. Most of the mucosal HPV infections in infants are incident, persistent infections in oral and genital mucosa being found in less than 10% and 2% respectively. The mother seems to be the main transmitter of HPV to her newborn, but subsequent HPV infections are acquired horizontally via saliva or other contacts. Bimodal peak prevalence is seen for skin warts, oral papillomas and recurrent respiratory papillomatosis (RRP) in younger and older age groups, suggesting similar epidemiology. Of the clinical HPV diseases, juvenile-onset-RRP and genital condylomata are problematic; the former because of its life-threatening potential and the latter because of possible sexual abuse. HPV6 and 11 are the most common genotypes in both the lesions. Early in life, infections by the high-risk HPV genotypes may also remain persistent for a considerable period, and should be of considerable importance for HPV vaccination strategies.

Human papilloma virus infection prior to coitarche

The aim of our study was to determine the prevalence and the natural course of anogenital human papilloma virus (HPV) infections in girls prior to coitarche attending an outpatient gynecological unit. Specimens were taken from the anogenital region of 114 unselected 4-15 year old girls who were referred consecutively for various gynecological problems. Four girls were excluded because of sexual abuse. Low-risk HPV-deoxyribonucleic acid (DNA) was detected in 4 girls (3.6%) and high-risk HPV DNA in 15 children (13.6%). Two girls testing positive for HPV DNA had clinical apparent warts. After 1 year, 2 children had persistent high-risk HPV DNA, and in 1 case we found a switch from high-risk to low-risk HPV DNA. Subclinical genital low- and high-risk HPV infections are common in girls without any history of sexual abuse or sexual activity. We found persistence of genital HPV infection in children, which could be a reservoir for HPV-associated diseases later in life.

Human papillomavirus infections in children.

The human papillomavirus is a ubiquitous 55-nm DNA virus that causes a variety of clinical disease states in children, commonly referred to as warts. The natural history of warts is spontaneous regression through the development of a complex blend of cell-mediated and humoral immunity. Although spontaneous immunity can develop, as many as one third of children will have persistent human papillomavirus infection beyond 2 years. Therapeutic modalities are manifold, primarily because no therapy is universally effective. The purpose of this review is to update the reader with the latest information on the human papillomavirus and its therapeutics in children. Recently, encouraging research has been conducted in human papillomavirus, including destructive and immunologic therapies. Vaccines tailored to genital human papillomavirus strains are just coming into clinical use. Manipulation of the immune system through medications or vaccination will likely help contain human papillomavirus in the future and prevent secondary human papillomavirus oncogenesis of the skin and cervix.

Human papillomavirus infections in children: the potential role of maternal transmission.

To date, more than 100 types of human papillomavirus (HPV) have been identified. In the past 20 years, there has been an increasing interest in HPVs because of their potential role in the pathogenesis of malignant tumors. HPV infections are known to affect predominantly adult, sexually active age groups, whereas skin warts, at various anatomic sites, are usually associated with younger individuals. The modes of viral transmission in children remain controversial, including perinatal transmission, auto- and hetero-inoculation, sexual abuse, and, possibly, indirect transmission via fomites. Recent studies on perinatal infection with HPV have been inconclusive. It is still unclear how frequently perinatal infection progresses to clinical lesions, whether genital, laryngeal, or oral. Conflicting reports have been published on the prevalence of HPV infections in children. The current consensus is, however, that newborn babies can be exposed to cervical HPV infection of the mother. The detection rate of HPV DNA in oral swabs of newborn babies varies from 4% to 87%. The concordance of HPV types detected in newborn babies and their mothers is in the range of 57% to 69%, indicating that the infants might acquire the HPV infection post-natally from a variety of sources. HPV antibodies have been detected in 10% to 57% of the children, and there is usually no correlation between seropositivity and the detection of HPV DNA in either the oral or the genital mucosa. There is also evidence that transmission in utero or post-natal acquisition is possible. The mode of in utero transmission remains unknown, but theoretically the virus could be acquired hematogenously, by semen at fertilization, or as an ascending infection in the mother. The understanding of viral transmission routes is important, particularly because several vaccination programs are being planned worldwide. The serologic response to HPV detected in different populations of young women or women at risk of cervical cancer might be due to genital infections, but the possibility that HPV infection has been acquired earlier in life through the oral mucosa or respiratory tract cannot be ruled out.

Histologic Correlates of Vulvar Human Papillomavirus Infection in Children and Young Adults

Two clinically important issues in the treatment of vulvar wartlike lesions are the histologic criteria for the recognition of human papilloma virus (HPV)-related lesions and the exclusion of lesions derived from cutaneous rather than genital HPV types. We analyzed a series of 70 biopsies from the vulva or distal vagina of 57 children and 13 young adults for HPV nucleic acids by polymerase chain reaction (PCR) amplification and typed the isolates following isotope labeling and restriction digestion (restriction fragment length polymorphism [RFLP] analysis). Lesions were classified as condyloma, suggestive of condyloma (papillary/verrucous architecture without koilocytotic atypia), or nonspecific epithelial alterations. Three observers independently agreed on the presence of papillary/verrucous architecture and koilocytotic atypia with a high degree of concordance (kappa = 0.74 and 0.71, respectively). By RFLP analysis, 77% of the lesions diagnosed as condyloma and 68% of those diagnosed as suggestive of condyloma contained HPV nucleic acids versus 9% of the nonspecific group. The HPV types identified were HPV 6 (67%), HPV 11 (17%), HPV 16 (3%), and unknown types (14%). No cutaneous HPV types were identified. Three patients with unknown HPV types had a history of sexual abuse, implying a genital source. These findings indicate that verrucopapillary external genital lesions, as defined in this report, are likely to be associated with HPV and that the vast majority contain genital HPV types irrespective of histologic presentation.

Human papillomavirus infections in children.

Human papillomavirus infections in children, particularly when occurring as condylomata acuminata, present a difficult and often puzzling problem. The possibility that the lesions were acquired through sexual contact mandates a careful and thorough evaluation. Even then, the source of the infection may be elusive because of a long latency between inoculation and the development of lesions, the secretive milieu of childhood sexual abuse, and lack of data about modes of transmission. New molecular techniques of HPV DNA detection and typing have not proven to be helpful in determining the source of the infection but may assist in identifying children who are at risk for the development of carcinoma. Various treatment modalities have been attempted with a significant percentage of recurrences. Many unanswered questions remain regarding the biology and epidemiology of HPV in children and adults. Clinical and basic science research specifically designed to address the concerns of the pediatric age group is urgently needed.

Detection of HPV DNA in genital condylomata acuminata in female prepubertal children

Abstract In situ DNA hybridization using biotin-labeled probes for HPV types 6, 11, 16, and 18 was performed on paraffin-embedded anogenital condylomata acuminata from four children. Three, age 9 years, 22 months, and 10 months, were positive for human papillomavirus (HPV) 6. The first two were also positive for HPV 11. A fourth child, age 6 years, was negative for all four HPV types. The mother of the 10-month-old infant had a condylomatous infection of the cervix as detected by cytology, histology, and colposcopy but dot blot hybridization of cervical tissue was negative for the four HPV types. These cases form the nucleus of a long-term prospective study of anogenital HPV infection in children, as the significance of various HPV types of infection in differing anogenital locations is poorly understood.