Department of Oral Pathology and Oral Radiology, Institute of Dentistry and MediCity Research Laboratory, University of Turku, Finland.
APMIS. 2010 Jun;118(6-7):494-509. doi: 10.1111/j.1600-0463.2010.02620.x.
Current evidence is strong enough to conclude that human papillomavirus (HPV) can be transmitted both sexually and non-sexually. The debate on HPV infections in children still continues but it is more focused on HPV prevalence than on transmission modes. HPV DNA detection in amniotic fluid, foetal membranes, cord blood and placental trophoblastic cells all suggest HPV infection in utero, i.e. prenatal transmission. Based on recent meta-analysis, vertical transmission occurs in approximately 20% of cases. Most of the mucosal HPV infections in infants are incident, persistent infections in oral and genital mucosa being found in less than 10% and 2% respectively. The mother seems to be the main transmitter of HPV to her newborn, but subsequent HPV infections are acquired horizontally via saliva or other contacts. Bimodal peak prevalence is seen for skin warts, oral papillomas and recurrent respiratory papillomatosis (RRP) in younger and older age groups, suggesting similar epidemiology. Of the clinical HPV diseases, juvenile-onset-RRP and genital condylomata are problematic; the former because of its life-threatening potential and the latter because of possible sexual abuse. HPV6 and 11 are the most common genotypes in both the lesions. Early in life, infections by the high-risk HPV genotypes may also remain persistent for a considerable period, and should be of considerable importance for HPV vaccination strategies.
目前的证据足以得出结论，人乳头瘤病毒（HPV）既可以通过性传播，也可以通过非性传播。关于儿童 HPV 感染的争论仍在继续，但更多的是关注 HPV 的流行率，而不是传播模式。羊水、胎儿膜、脐血和胎盘滋养层细胞中 HPV DNA 的检测均提示宫内 HPV 感染，即产前传播。基于最近的荟萃分析，垂直传播的发生率约为 20%。大多数婴儿的黏膜 HPV 感染是偶发性的，口腔和生殖器黏膜的持续性感染分别不到 10%和 2%。母亲似乎是 HPV 向新生儿传播的主要媒介，但随后的 HPV 感染是通过唾液或其他接触水平获得的。皮肤疣、口腔乳头瘤和复发性呼吸道乳头瘤病（RRP）在年轻和老年人群中呈现双峰流行率，表明具有相似的流行病学特征。在临床 HPV 疾病中，青少年发病的 RRP 和生殖器尖锐湿疣是个问题；前者因为有生命威胁的可能性，后者因为可能存在性虐待。HPV6 和 11 是这两种病变中最常见的基因型。在生命早期，高危型 HPV 基因型的感染也可能持续相当长的时间，这对 HPV 疫苗接种策略具有重要意义。
