Human Papillomavirus Screening in Pediatric Victims of Sexual Abuse

Abstract

Objective. To evaluate for the presence of subclinical human papillomavirus (HPV) in cases of suspected sexual abuse in children. Design. Prospective data collection via interviews, physical examination, colposcopic examination, and tissue sampling by a surface swab technique. Setting. A total of 40 pediatric patients ranging in age from 1 to 16 years 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 examination for physical signs of abuse, the patients were screened for evidence of sexually transmitted diseases, including syphilis, gonorrhea, andChlamydia. At that time, surveillance sampling of the throat, vaginal introitus, and/or rectum by a simple, rapid surface swab technique was performed to detect the presence of HPV. Measurements. Template DNA was extracted from cotton swabs and analyzed using polymerase chain reaction analysis. Results. Human β-globin sequences were detected 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 other 56 specimens yielded evidence of HPV. Appropriate positive and negative controls were included in each assay. Conclusions. Our results suggest that subclinical HPV infection is possible, but not commonly associated with sexual abuse in children from St Louis, MO. In this group of children without condyloma, HPV 16 was the only type identified.