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Perinatal infection and persistence of human papillomavirus types 16 and 18 in infants
J Cason1, J N Kaye, R J Jewers
1Richard Dimbleby Laboratory of Cancer Virology, Department of Virology, Rayne Institute, London, United Kingdom.
Insights
Perinatal transmission of high-risk human papillomaviruses (HPVs) like HPV-16 and HPV-18 can occur, with DNA persisting in infants for months. This early-life infection is crucial for developing effective HPV vaccine strategies.
Area of Science:
- Virology
- Immunology
- Public Health
Background:
- Perinatal transmission of genital human papillomaviruses (HPVs), including high-risk types HPV-16 and HPV-18, has been previously documented.
- These HPV types are significant risk factors for developing anogenital carcinomas.
Purpose of the Study:
- To investigate the persistence of HPV-16 and HPV-18 DNA in infants up to six months of age after perinatal exposure.
- To determine the age of acquisition of IgM antibodies to HPV in children, suggesting potential transmission modes.
Main Methods:
- Recruitment of 61 pregnant women to assess HPV DNA presence in mothers and infants at birth, 24 hours, 6 weeks, and 6 months.
- Expression of HPV-16 L1 and L2 proteins in insect cells using recombinant baculoviruses.
- Examination of sera from 229 children for IgM antibodies to HPV to identify age of acquisition.
Main Results:
- High transmission rates of HPV-16 (69%) and HPV-18 (76.9%) from mothers to infants at 24 hours postpartum.
- Sustained HPV DNA persistence at 6 weeks (79.5%) and 6 months (HPV-16: 83.3%, HPV-18: 20%) in infected infants.
- Bimodal distribution of IgM seropositivity in children, peaking between 2-5 and 13-16 years, indicating potential dual transmission routes.
Conclusions:
- Early-life infection with high-risk genital HPVs is possible and can persist beyond infancy.
- The findings have significant implications for the timing and strategy of HPV vaccination programs.
- The observed bimodal antibody response suggests distinct pathways for HPV acquisition in childhood.
Abstract:
Perinatal transmission of genital human papillomaviruses (HPVs), including HPV-16 and -18 which are associated with anogenital carcinomas have been described previously [Pakarian et al. (1994): British Journal of Obstetrics and Gynaecology 101:514-517; Kaye et al. (1994) Journal of Medical Virology 44:415-421]. A study was undertaken to investigate whether HPV-16 and -18 DNA in infants contaminated at delivery persists until they are 6 months of age. Of 61 pregnant women recruited, 42 (68.8%) were HPV-16 and 13 (21.3%) were HPV-18 DNA positive. At 24 hr there were transmission rates from HPV DNA positive mothers to their infants of about 73% (HPV-16: 69%; HPV-18: 76.9%). Ten mothers who were both HPV-16 and -18 DNA positive produced six (60%) infants who were also doubly positive at 24 hr. HPV DNA persisted to 6 weeks in 79.5% (HPV-16: 84%; HPV-18: 75%) of those infants who were positive at birth. At 6 months of age, persistent HPV-16 DNA was detected in 83.3% of cases, but HPV-18 DNA persistence at this time was 20%. To extend these observations over a greater age range of children HPV-16 L1 and L2 proteins were expressed in insect cells via recombinant baculoviruses and sera from 229 children were examined to determine at what age IgM antibodies to HPV were acquired. There was a bimodal distribution of IgM seropositivity which peaked between 2 and 5 and 13 and 16 years of age, suggesting that two distinct modes of transmission may occur. The observation that infection with high cancer risk genital HPVs may occur in early life and persist is of considerable importance for HPV vaccine strategies.