Human Papillomavirus (HPV) in Children – Causes, Signs, and Treatment

Human Papillomavirus, or HPV, is a sexually transmitted infection common in all populations globally. The virus will infect 80% of people at some point in their lives. So, it is neither rare nor is it a cause for shame. While HPV infections in children can be sensitive and even scary, it is important to know and understand. Understanding the cause of the virus, its treatment, and prevention is essential to reduce its worldwide prevalence. If you are a parent who has recently heard about this virus, then continue reading about the causes, signs, and methods of treatment associated with Human Papillomavirus in children.

What Is Human Papillomavirus (HPV)?

Human Papillomaviruses are common microorganisms that cause a wide range of infections in adults and children. Different strains of HPV are responsible for genital warts, common warts, low and high-grade squamous intraepithelial lesions (abnormal growth of squamous cells), and even recurrent respiratory papillomatosis. Squamous intraepithelial lesions (or SIL) are considered a precancerous stage and can lead to cervical cancer if not detected and treated early.

Although HPV will increase the chances of developing cervical cancer, not every child with HPV will develop cervical cancer. HPV in kids affects two different types of tissue. One is cutaneous, like skin. And the other is mucosal, like HPV in children’s throat, the vaginal wall, the penis, the cervix, etc. Since HPV causes contact infection, it means that the virus resides in the cells nearest to the point of infection rather than spreading throughout your entire body.

Furthermore, since HPV is most often transferred through sexual activity, certain cells are at risk. Current data indicates that the infection is potentially associated with 90% anal cancers, 12-63% oropharyngeal cancers, 36-40% penile cancers, 40-64% vaginal cancers, and 40-51% vulvar cancers.

The Discovery of anogenital warts in children has legal and clinical implications because such warts are usually a sexually transmitted infection (STI). Due to this, the evaluation of children for possible sexual abuse should always be considered. There are over 200 types of HPV. The body’s immune system can eradicate most strains before they cause any harm. Certain other strains like HPV 6 and 11 cause abnormalities in the infected tissue cells, developing into genital warts. While this may be worrying, the use of prescribed topical creams can help eliminate these warts without causing long-term damage to your health.

Another 13 streams of HPV can cause cells to develop rapidly, leading to cancerous growth. In particular, the cells of the cervix are at risk. HPV strains 16 and 18 cause approximately 70 percent of cervical cancers worldwide. These strains take as long as 20 years to develop into cancer. With regular screening, you can prevent this progression. 

What Causes HPV in Children?

Human Papillomavirus can spread to children through:

• Sex
• Certain forms of skin-to-skin contact

Even though HPV is called an STI (sexually transmitted illness), in some cases, the Human Papillomavirus Infection in children can also be transmitted through non-sexual routes such as hand-to-hand contact or from a mother to child during vaginal delivery. 

Symptoms of HPV in Children

Warts are the most common signs of HPV in children and the only externally visible symptom for HPV. The signs depend on the kind of wart developed on the skin. So, some types of warts that could be symptoms of HPV are:

• Genital warts: Genital warts can present as raised bumps or flat spots. Women usually grow them on the vulva but can also appear in the vagina, cervix, and even anus. It commonly occurs on the penis, scrotum, or anus in men.
• Common warts: These are rough bumps that generally appear on the hands and fingers.
• Plantar warts: These are hard, grainy, and painful bumps that show up on the bottom of the feet.
• Flat warts: Flat warts are visibly raised spots with a flat top. They can appear anywhere but are seen most commonly on the face and legs.

Types of Cancers Caused by HPV

HPV can cause several cancers, each with its percentage of possibility. A few classes of cancers that can be brought by HPV are:

1. Anal cancer

Anal cancer is a type of cancer where malignant cells develop in the anal tissues. Signs of the disease include bleeding from the anus or rectum and a lump near the anus in some cases.

2. Oropharyngeal cancer

In oropharyngeal cancer, malignant cells develop in the oropharyngeal tissues. Signs and symptoms of oropharyngeal cancer include a lump in the neck and a sore throat.

3. Penile cancer

The cancer cells develop both on the penis or inside in this disease. It typically starts on the skin cells and makes its way inside.

4. Vaginal cancer

Vaginal cancer is rare. However, in women, it typically occurs in the cells that line the surface of the birth canal.

5. Vulvar cancer

Vulvar cancer is a type of cancer that develops in the outer region of the female genitalia. The cancer commonly shows as a lump or sore on the vulva and is often itchy.

Risks of HPV in Children

Once we understand the risks associated with HPV, it is possible to prevent infections in children. The following are some risk factors of HPV that can increase the chance of a child developing an HPV infection:

• Having an open cut: The infection can enter the bloodstream through the opening in the skin.
• Mother with infection: The infection may be transferred to the child during vaginal childbirth.
• Sexual activity: Those that are sexually active, have multiple sexual partners, or have been with a partner that has had multiple partners have a greater risk of contracting HPV.
• Weak immunity: A weakened immune system, caused by either disease or immune-suppressing medications, will increase the chances of contracting the infection.

How Is HPV Diagnosed in a Child?

Warts are used to diagnose HPV infection in most cases. Additional interventions, such as an endoscope, may be required in some cases. However, a definitive diagnosis of HPV cannot be made without molecular testing of biopsied cells for viral DNA or RNA.

Complications of HPV in Children

While the virus itself is harmful, it can lead to further complications affecting the child’s health even more. Some of the complications include:

• Oral and upper respiratory lesions: Some HPV infections cause lesions inside the mouth in places such as the tongue and soft palate. It can also occur in the throat on the tonsils, and even inside the nose and larynx.
• Cancer: Some strains of HPV can cause cervical cancer in girls. They are also known to contribute to cancers of the anus, genitals, mouth, and upper respiratory tract.

Treatments of HPV in Children

Due to the varied nature of the virus and the various complications associated with it, there are many forms that the treatment for the virus can be done in children. These treatment options include:

1. Wart removal

Treatments often involve removing warts and precancerous lesions with salicylic acid products, liquid nitrogen cryotherapy, laser removal, or surgical removal.

2. Immune modifiers

In cases of frequent reoccurrences, immune modifiers may be used to boost the immune system to remove the infection on its own.

3. Self-recovery

Most HPV infections in younger people can resolve on their own over time, particularly in low-risk types. However, limiting contact with potentially infected persons and administering the vaccines are the most effective courses for protecting children.

How Can You Prevent HPV?

HPV can be prevented by taking care of the different symptoms and warts early. By addressing such factors, here are some ways to prevent HPV:

1. Common warts: The types of HPV infections that cause common warts are hard to prevent. Once a wart is formed, you can prevent the spread of the infection not picking on it and by not biting your nails.
2. Plantar warts: Wearing shoes or closed sandals in high-risk areas such as public pools and locker rooms can lower the chances of contracting HPV infections that cause plantar warts.
3. Genital warts: There are a few different ways to reduce the risk of getting genital warts – being in a mutually monogamous sexual relationship, reducing the number of sexual partners, and using latex condoms.

HPV Vaccines for Children

Cervical cancer is easily preventable through vaccination, which is 97-100% effective against HPV strains that cause genital warts and cervical cancer. The HPV vaccine schedule for children consists of three doses, administered several months apart, spanning one year in total. And they are only effective if all three doses are administered. Vaccinations for boys and girls can be started as early as age 9.

So, to answer the question, “When can my child receive the HPV vaccination?” is to administer it around the ages of 11 and 12. However, it can also be administered starting from the age of 9.

The vaccine’s effectiveness is maximized when administered to a child between ages 11 and 12. Although it is uncommon to be exposed to the virus at this age, the potential for infection steadily increases during puberty and beyond when there is an increased likelihood of engaging in intimate relationships. Studies have not shown any connection between the vaccine and increased sexual activity. The vaccine prevents an HPV infection when this activity may naturally occur.

How to Know If HPV Vaccine Is Safe for Children?

HPV vaccines have been through many safety testing and are not associated with any serious safety concerns. The vaccine will not cause HPV, cancer, or infertility. To be doubly certain, please check with your doctor about the safety of HPV vaccines for your child.

Side Effects of HPV Vaccine

A common side effect the child might experience is temporary pain or mild discomfort near the area where the shot was given.

The vaccine works by prompting the body’s immune system to produce antibodies to protect against future infections from HPV. Sometimes people hesitate to take the vaccines because they think they are being injected with the live virus, but that is not the case. The patients are infected with a protein that the virus produces, and that’s how the body distinguishes the virus as a foreign body. 

What Are the Myths of HPV Vaccine?

The following are some unfounded myths generally associated with the HPV vaccine:

1. My child is too young, and they don’t need the vaccine yet.
2. You can only get HPV if you are sexually active.
3. Giving my child HPV vaccine will make them sexually active.
4. Getting the vaccine will guarantee my child does not contract HPV.
5. HPV only affects females, so my son does not need the HPV vaccine.
6. The vaccine is new, so it must not be safe enough to give my child.
7. My child does not need the HPV vaccine. If they contract HPV, we’ll treat it.
8. Getting the HPV vaccine will affect my child’s fertility later in life.

Administering the HPV shot is the most important step in protecting children from developing more serious conditions. For cancer survivors, it is especially important to be vaccinated to prevent another type of cancer from occurring. When it comes to vaccine hesitancy, there is no valid medical reason why the vaccine shouldn’t be administered to children at the earliest. 

Also Read:

Norovirus in Kids

Herpangina in Kids

Respiratory Syncytial Virus (RSV) in Children