Genital HPV infections in pregnancy
Karla Kovačević, Mihael Skerlev, Hrvoje Vrčić, Petra Kovačević, Suzana Ljubojević Hadžavdić
Human papilloma viruses (HPV) are small, epitheliotropic DNA viruses. More than two hundred different HPV genotypes are known today, of which around forty types cause genital infection. According to their oncogenic potential the viruses are divided in high-risk HPV genotypes (HPV 16, HPV 18, etc.) and low-risk genotypes (HPV 6, HPV 11, etc.). Genital HPV is most frequently transmitted through contact with infected skin or mucous membranes. Other routes of transmission are via contaminated fomites and autoinoculation. HPV causes genital warts, intraepithelial neoplasia and invasive carcinoma of cervix, vulva, penis or anus.Also, HPV can cause lesions in non-genital areas such as oral cavity, pharynx, throat and esophagus. There is no consensus regarding the prevalence of HPV during pregnancy, so it varies in different countries between 5.5 % and 65 %. The otential route of HPV transmission from mother to child during pregnancy is known as vertical transmission. Periconceptual transmission of HPV DNA occurs during fertilization, while prenatal transmission happens only during pregnancy. Most infant HPV infections occur via perinatal transmission during delivery. The incidence of anogenital warts in pregnancy is between 11.6 % and 28.2 %. Anogenital warts increase the risk of infant HPV contamination during delivery. As the incidence of anogenital warts increased in adults, increased incidence was also reported in children. HPV can cause recurrent respiratory papillomatosis in children, a disease characterized with laryngeal papillomatosis. In rare cases, total obstruction of airway or progression in carcinoma can occur.