CANCER-ASSOCIATED HUMAN PAPILLOMAVIRUSES - PERINATAL TRANSMISSION ANDPERSISTENCE

Objective To demonstrate the perinatal transmission and persistence of the cancer associated human papillomavirus types 16, 18, 31 and 33. D esign Cervical swabs were taken from pregnant women between 20 and 38 weeks of gestation. Buccal and genital swabs were taken from infants a t 24 h and at six weeks after delivery and examined for HPV-16, -18, - 31 and -33 DNA by the polymerase chain reaction. Setting Maternity Uni t at St Thomas' Hospital, London. Subjects Thirty-one pregnant women, 16 with a previous history of cervical intraepithelial neoplasia or ge nital warts, or both, and their 32 infants (one set of twins). Results Twenty of the 31 (65 %) women were positive for HPV-DNA prior to deli very. Twelve of 32 (38 %) and eight of 31 (26 %) infants were HPV-DNA positive at 24 h and six weeks respectively. Swabs taken at 24 h demon strated HPV type 16 in five mother-infant pairs and HPV type 18 in two mother-infant pairs. Dual infections with HPV types 16 and 18 were de monstrated in swabs from three mother-infant pairs. At six weeks, HPV- 16 was demonstrated in swabs from six infants and HPV-18 in swabs from two infants. Conclusions Perinatal transmission of human papillomavir us types 16 and 18 occurred in 55 % cases. Persistent human papillomav irus infection was demonstrated at six weeks of age. Whether acquisiti on of human papillomavirus during the perinatal period predisposes to an increased risk of cervical intraepithelial neoplasia among female i nfants in later life remains to be established. Information on the per sistence of perinatally acquired human papillomavirus is required befo re rational vaccination programmes can be considered.