HUMAN-PAPILLOMAVIRUS SCREENING IN PEDIATRIC VICTIMS OF SEXUAL ABUSE

Objective. To evaluate for the presence of subclinical human papilloma virus (HPV) in cases of suspected sexual abuse in children. Design. Pr ospective data collection via interviews, physical examination, colpos copic examination, and tissue sampling by a surface swab technique. Se tting. A total of 40 pediatric patients ranging in age from 1 to 16 ye ars who were referred to the Special Assessment and Management Clinic at Cardinal Glennon Children's Hospital, St Louis, MO, for probable or confirmed sexual abuse. Interventions. In addition to colposcopic ex amination for physical signs of abuse, the patients were screened for evidence of sexually transmitted diseases, including syphilis, gonorrh ea, and Chlamydia. At that time, surveillance sampling of the throat, vaginal introitus, and/or rectum by a simple, rapid surface swab techn ique was performed to detect the presence of HPV. Measurements. Templa te DNA was extracted from cotton swabs and analyzed using polymerase c hain reaction analysis. Results. Human beta-globin sequences were dete cted in 58 (83%) of 70 specimens obtained from 40 patients, indicating successful processing had occurred. Using a consensus L1 primer-probe set capable of detecting multiple HPV genotypes, 2 (3%) of 58 samples from 2 (5%) of 40 patients were positive for HPV 16. None of the othe r 56 specimens yielded evidence of HPV. Appropriate positive and negat ive controls were included in each assay. Conclusions. Our results sug gest that subclinical HPV infection is possible, but not commonly asso ciated with sexual abuse in children from St Louis, MO. In this group of children without condyloma, HPV 16 was the only type identified.