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February 11, 2021
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HPV in young children most prevalent at birth

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A Finnish study involving more than 300 children found that oral HPV was prevalent in nearly 23% of newborns and persisted in approximately 15% of children for a mean of about 20 months, researchers reported in Emerging Infectious Diseases.

Stina Syrjänen, DDS, PhD, a professor and chair emerita in the department of oral pathology at the University of Turku, and colleagues assessed oral scrapings for HPV from 324 infants (171 girls, 153 boys) at birth, after 3 days of life, 1 month of age, 2 months, 6 months, 12 months, 24 months, 36 months, and then after 6 years of age.

Source: Shutterstock.com
Source: Shutterstock.com

The investigators reported that the prevalence of oral HPV was highest at birth — 22.8% — but that “positivity at birth or later was unrelated to the mode of delivery.” The prevalence declined to a low of 8.7% at the 3-year visit, with only four genotypes identified — HPV16, HPV18, HPV6 and HPV11 — and then increased to 20.4% at the 6-year visit, with eight genotypes identified. Overall, 41.4% (135 of 329) children remained negative for all oral samples of HPV.

Investigators identified 18 different HPV genotypes in participants, with HPV16 being the most prevalent, followed by HPV18, HPV6, HPV33 and HPV31 — all of them high-risk types, except HPV6. Genotype distribution was widest at time of birth, with 15 different types, and the frequency of multi-type infections was at its highest at 3.7%.

The authors reported that high-risk HPV seropositivity was associated with oral high-risk HPV incidence for fathers and clearance for children, whereas oral carriage for mothers, as well as high-risk HPV seroconversion, was associated with high-risk HPV for children — OR for oral carriage, 1.92 (95% CI, 1.35-2.74); and for high-risk HPV seroconversion, 1.60 (95% CI, 1.02-2.50).

“Our study strongly supports the hypothesis that HPV can be transmitted vertically and cause a true infection of oral mucosa of the newborn,” the authors wrote. “Some of these oral HPV infections acquired at birth can also persist for years without any major clinical lesions.”