A POSSIBLE VERTICAL TRANSMISSION OF HUMAN-PAPILLOMAVIRUS GENOTYPES ASSOCIATED WITH EPIDERMODYSPLASIA-VERRUCIFORMIS

Epidermodysplasia verruciformis (EV) is characterized by an abnormal g enetic susceptibility to a group of related human papillomavirus (HPV) genotypes, including the oncogenic HPV5 and HPV8. The mode of transmi ssion of these viruses remains unknown. In view of the rare incidence of EV, we had a unique opportunity to perform a virologic study of the amniotic fluid and placenta from an EV patient infected with HPV5, HP V8, several other EV HPV, and HPV3. The child was born by cesarean sec tion and the amniotic fluid specimen was taken prior to rupture of mem branes, Analysis of the amniotic fluid and placenta specimens by a nes ted polymerase chain reaction method, using degenerate EV HPV primers or type-specific HPV primers, disclosed the presence of the variants o f EV HPV5, HPV8, HPV24, and HPV36, and of HPV3 detected in the skin le sions of the patient. HPV5, HPV8, HPV24, and HPV3 were also detected i n the placenta. No viral sequences were detected in peripheral blood m ononuclear cells collected 2 y and 6 mo before cesarean section, rende ring an hematogenous transmission unlikely. The same HPV variants were also detected in cervical scrapes taken from the patient, which may s uggest an ascending infection of the placenta. This first report of th e detection of EV HPV in amniotic fluid, placenta, and cervical scrape s from an EV patient renders vertical transmission of EV HPV likely.