HPV infection not uncommon in girls before sexual activity

Positive tests for human papillomavirus (HPV) in young girls who were not yet sexually active suggest a wider subclinical prevalence of HPV infection than previously thought, according to a study reported in the May issue of the American Journal of Obstetrics and Gynecology.

Daniela Doerfler, MD, of the Medical University of Vienna in Austria, and colleagues took anogenital specimens from 114 girls aged 4 to 15 prior to coitarche, who came to a gynecological clinic for various problems. After examination, four girls were excluded from the study because of sexual abuse. The specimens were tested for HPV.

The researchers detected low-risk HPV-deoxyribonucleic acid (DNA) in four of the girls (3.6%) and high-risk HPV DNA in 15 of the girls (13.6%). Two of the girls with a positive test also had genital warts. At 1-year follow-up, two of the girls still had high-risk HPV DNA, while one girl who previously tested positive for high-risk HPV DNA had low-risk HPV DNA.

"Our study demonstrates for the first time that subclinical HPV infection is also common in girls prior to coitarche without any history of sexual abuse or consensual sexual activity. Therefore, we recommend being very careful when suspecting sexual abuse only on the basis of positive HPV testing. On the other hand, HPV testing in population-based representative sample of young girls could be crucial to decide whether vaccination against HPV at a younger age is more beneficial than the current practice," the authors write.

Doerfler D, Bernhaus A, Kottmel A, et al. Human papillomavirus infection prior to coitarche. Am J Obstet Gynecol. 2009;200:487.e1-487.e5.