Against: High risk genital papillomavirus infections are not spread vertically

The Medline-indexed literature on risk factors for HPV infection and HPV tr ansmission is critically reviewed. Principles for assay validation and inte rpretation, reliability of different study designs and principles for inter pretation of conflicting reports are discussed. The conclusions arrived at can be summarised as: (1) There is overwhelming epidemiological evidence th at the only quantitatively important mode of transmission of infection with oncogenic genital HPV types is sexual. (2) There is also evidence that ben ign genital HPV types can be transmitted sexually, but the epidemiological data on the benign virus types are less extensive and less clear. (3) Perin atal HPV transmission is unequivocally demonstrated only for the rare disea se juvenile respiratory papillomatosis. Copyright (C) 1999 John Wiley & Son s, Ltd.