Transmissão de verrugas anogenitais em crianças e associação com abuso sexual

Autores

  • Jefferson Drezett Hospital Pérola Byington; Centro de Referência da Saúde da Mulher; Núcleo de Violência Sexual e Abortamento
  • Raquel Molina de Vasconcellos Hospital Pérola Byington; Centro de Referência da Saúde da Mulher; Núcleo de Violência Sexual e Abortamento
  • Daniela Pedroso Hospital Pérola Byington; Centro de Referência da Saúde da Mulher; Núcleo de Violência Sexual e Abortamento
  • Marcia de Toledo Blake Faculdade de Medicina do ABC; Laboratório de Escrita Científica
  • Adriana Gonçalves de Oliveira Faculdade de Medicina do ABC; Laboratório de Escrita Científica
  • Luiz Carlos de Abreu Faculdade de Medicina do ABC; Laboratório de Escrita Científica

DOI:

https://doi.org/10.7322/jhgd.20047

Palavras-chave:

infecções por papillomavirus, maus-tratos sexuais infantis, condiloma acuminado, transmissão vertical de doença infecciosa, violência doméstica

Resumo

INTRODUÇÃO: A incidência do condiloma acuminado anogenital em crianças mostra notável aumento nas últimas duas décadas, bem como o interesse por sua associação com o abuso sexual. No entanto, essa relação apresenta controvérsias quanto à etiologia da infecção, o que torna o atendimento desafiador, particularmente nos aspectos ético-legais. OBJETIVO: Revisão da literatura sobre transmissão do HPV em crianças e relação com abuso sexual. MÉTODO: Síntese de dados da consulta ao Journal Citation Reports (JCR-ISI), Medical Literature Analysis and Retrieval System Online (Medline), Scientific Eletronic Library Online (Scielo) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs). Foram utilizados descritores MeSH Terms com sintaxes (HPV [All Fields]) AND ("Child Abuse, Sexual" [MeSH Terms]). Artigos relevantes entre 1989 e 2009 foram selecionados. Aspectos ético-legais foram consultados na legislação penal e Estatuto da Criança e do Adolescente. RESULTADOS: Diferentes formas de transmissão não sexual do HPV em crianças estão documentadas, destacando-se a transmissão vertical, auto e heteroinoculação de verrugas cutâneas, e aquisição por instrumentos. Estudos são discordantes quanto à aplicabilidade do DNA-HPV para diferenciar a transmissão sexual e não sexual das verrugas anogenitais. CONCLUSÃO: Evidências indicam que em crianças com menos de dois anos de idade a transmissão não sexual do HPV deve ser fortemente considerada na ausência de lesões genitais, de outra DST, ou de história consistente de abuso. A probabilidade de associação entre HPV e abuso sexual aumenta diretamente com a idade, principalmente após os cinco anos.

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Publicado

2012-04-01

Edição

v. 22 n. 1 (2012)

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Pesquisa Original

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