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HPV in children may point to sexual abuse, or not

Posted on: Monday, 3 October 2005, 14:36 CDT

NEW YORK (Reuters Health) - HPV, the virus that causes genital warts, is usually thought of as a sexually transmitted disease, but it can also be spread in other ways. Therefore, when a child is found to be infected, the possibility of sexual abuse has to be considered.

Although most cases of HPV, or human papillomavirus, in very young children are the result of non-sexual transmission, a medical evaluation should be conducted, researchers say in the medical journal Pediatrics.

There is disagreement regarding the origin of HPV in children, senior investigator Dr. Sara H. Sinal told Reuters Health.

So Sinal and her colleagues at Wake Forest University in Winston-Salem, North Carolina, examined the records of children younger than 13 years old who were found to have HPV infections between 1985 and 2003, as well as records of 1565 children younger than 13 years old who were examined in the child sex abuse clinic between 1993 and 2002.

Dr. Sinal's group identified 124 children with HPV. The possibility of sexual abuse was considered in 71 (57 percent) HPV cases, and 55 (44 percent) were referred to the child sex abuse clinic for evaluation. Of these, 17 were considered likely to have been sexually abused.

"I think that for every child who has HPV, even in the larynx, you probably at least need to do some screening for sex abuse," Sinal said.

In her study, abused children were older than those who had not been abused.

"If the child is under 4 years of age and there are no other findings of abuse -- parents aren't suspicious, there are no behaviors to suggest abuse, physical exam is normal, the patient is negative for all other STDs -- if all of that is negative, then I'm not inclined to report them to social services," Sinal added.

It is possible that some cases are transmitted through the birth canal or from warts on the parents' hands, she noted. "But the older they are, the more likely it is to have occurred as a result of sexual abuse," the researcher added.

"We also have to raise the sensitivity of parents to the possibility" of sexual abuse, she added. "So we tell parents that we see no evidence of sexual abuse now, but as the child gets older if there are other symptoms or disclosure then we need to re-evaluate that child."

SOURCE: Pediatrics, October 2005.

Source: REUTERS

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