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:: Volume 33, Issue 6 (1-2026) ::
Journal of Ilam University of Medical Sciences 2026, 33(6): 137-148 Back to browse issues page
Review of sexual and nonsexual transmission routes of human papillomavirus: evidence and challenges
Azra Kenarkoohi *
Dept of Laboratory Sciences, School of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran , a.kenarkoohi@gmail.com
Abstract:   (24 Views)
Introduction:  Although sexual contact has been definitively proven to be the main route of human papillomavirus transmission, many questions remain about nonsexual transmission of papillomavirus.
Materials & Methods: This study was a narrative review aimed at investigating the transmission routes of human papillomavirus (HPV). A PubMed, Google Scholar, and Web of Science databases search was conducted to identify relevant studies up to March 2025.
Results: The high persistence of the virus in the environment and its resistance to common disinfectants increase the risk of transmission through nonsexual routes. In addition, scientific evidence that HPV DNA has been detected in the blood of healthy donors has raised concerns about the transmission of papillomavirus through blood and blood products.
Conclusion: These findings present new challenges for the study and prevention of human papillomavirus transmission. This article provides a comprehensive analysis of the definitive and probable routes of papillomavirus transmission based on available scientific evidence.
Keywords: Papillomavirus, sexual transmission, non-sexual transmission, breast milk, hospital infection, blood
Full-Text [PDF 677 kb]   (15 Downloads)    
Type of Study: Applicable | Subject: infectious diseases
Received: 2025/10/5 | Accepted: 2025/10/28 | Published: 2026/01/28
References
1. Toh ZQ, Zhao F, Zhang L, Wei L, Zou H. Editorial: HPV natural history, immunological responses and vaccination strategies: challenges and opportunities. Front Immunol. 2024;14:1349664. doi: 10.3389/fimmu.2023.1349664.
2. Falahi S, Arvaneh K, Nourmohammadi H, Abdoli A, Bozorgomid A, Kenarkoohi A. Prevalence and genotyping of human papillomavirus DNA in peripheral blood mononuclear cells from blood donors in Iran. New Microbes New Infect. 2025;65:101593. doi: 10.1016/j.nmni.2025.101593.
3. Taguchi A, Yoshimoto D, Kusakabe M, Baba S, Kawata A, Miyamoto Y, et al. Impact of human papillomavirus types on uterine cervical neoplasia. J Obstet Gynaecol Res. 2024;50:1283-1288. doi: 10.1111/jog.15995.
4. Shakurnia A, Salehpoor F, Ghafourian M, Nashibi R. Knowledge and attitudes toward HPV, cervical cancer and HPV vaccine among healthcare providers in Ahvaz, Southwest Iran. Infect Agent Cancer. 2025;20:44. doi: 10.1186/s13027-025-00669-9.
5. Sibeko S, Sanderson M, Moyo S, Botha MH. Role of the epithelium in human papillomavirus and human immunodeficiency virus infections in the female genital tract. Front Reprod Health. 2024; 6:1408198. doi: 10.3389/frph.2024.1408198.
6. Lycke KD, Steben M, Garland SM, Woo YL, Cruickshank ME, Perkins RB, et al. An updated understanding of the natural history of cervical human papillomavirus infection—clinical implications. Am J Obstet Gynecol. 2025;232:453-60. doi: 10.1016/j.ajog.2025.02.029.
7. Wierzbicka M, San Giorgi MRM, Dikkers FG. Transmission and clearance of human papillomavirus infection in the oral cavity and its role in oropharyngeal carcinoma - A review. Rev Med Virol. 2023;33:e2337. doi: 10.1002/rmv.2337.
8. Rintala MAM, Grénman SE, Puranen MH, Isolauri E, Ekblad U, Kero PO, et al. Transmission of High-Risk Human Papillomavirus (HPV) between Parents and Infant: a Prospective Study of HPV in Families in Finland. J Clin Microbiol. 2005;43:376-81. doi: 10.1128/JCM.43.1.376-381.2005.
9. Jones V, Smith SJ, Omar HA. Nonsexual transmission of anogenital warts in children: a retrospective analysis. ScientificWorldJournal. 2007;7:1896-9. doi: 10.1100/tsw.2007.276.
10. Han J, Zhang L, Chen Y, Zhang Y, Wang L, Cai R, et al. Global HPV vaccination programs and coverage rates: a systematic review. EClinicalMedicine. 2025;84:103290. doi: 10.1016/j.eclinm.2025.103290.
11. Cladel NM, Jiang P, Li JJ, Peng X, Cooper TK, Majerciak V, et al. Papillomavirus can be transmitted through the blood and produce infections in blood recipients: Evidence from two animal models. Emerg Microbes Infect. 2019;8:1108-21. doi: 10.1080/22221751.2019.1637072.
12. LaCour DE, Trimble C. Human papillomavirus in infants: transmission, prevalence, and persistence. J Pediatr Adolesc Gynecol. 2012;25:93-7. doi: 10.1016/j.jpag.2011.03.001.
13. Liu M, He Z, Zhang C, Liu F, Liu Y, Li J, et al. Transmission of genital human papillomavirus infection in couples: a population-based cohort study in rural China. Sci Rep. 2015;5:10986. doi: 10.1038/srep10986.
14. Malagón T, Louvanto K, Wissing M, Burchell AN, Tellier P-P, El-Zein M, et al. Hand-to-genital and genital-to-genital transmission of human papillomaviruses between male and female sexual partners (HITCH): a prospective cohort study. Lancet Infect Dis. 2019;19:317-26. doi: 10.1016/S1473-3099(18)30655-8.
15. Shew ML, Weaver B, Tu W, Tong Y, Fortenberry JD, Brown DR. High frequency of human papillomavirus detection in the vagina before first vaginal intercourse among females enrolled in a longitudinal cohort study. J Infect Dis. 2013 Mar 15;207:1012-5. doi: 10.1093/infdis/jis775.
16. Ryndock EJ, Meyers C. A risk for non-sexual transmission of human papillomavirus? Expert Rev Anti Infect Ther. 2014; 12:1165-70. doi: 10.1586/14787210.2014.959497.
17. Sabeena S, Bhat P, Kamath V, Arunkumar G. Possible non‐sexual modes of transmission of human papilloma virus. J Obstet Gynaecol Res. 2017;43:429-35. doi: 10.1111/jog.13248.
18. Sonnex C, Strauss S, Gray J. Detection of human papillomavirus DNA on the fingers of patients with genital warts. Sex Transm Infect. 1999;75:317-9. doi: 10.1136/sti.75.5.317.
19. Duan X, Pan J, Wang X, Liu W, Ping Y, Yu P, et al. Monitoring the presence of human papillomavirus in public areas indicates non-sexual transmission of the virus and environmental risk. BMC Public Health. 2025;25:1907. doi: 10.1186/s12889-025-22319-w.
20. Bénard EA, Carceller AM, Mayrand MH, Lacroix J, Niyibizi J, Laporte L, et al. Viral Load of Human Papillomavirus (HPV) during pregnancy and its association with HPV vertical transmission. J Med Virol. 2025;97:e70221. doi: 10.1002/jmv.70221.
21. Tseng C-J, Liang C-C, Soong Y-K, Pao C-C. Perinatal transmission of human papillomavirus in infants: relationship between infection rate and mode of delivery. Obstet Gynecol. 1998;91:92-6. doi: 10.1016/s0029-7844(97)00593-0.
22. Syrjanen S, Puranen M. Human papillomavirus infections in children: the potential role of maternal transmission. Crit Rev Oral Biol Med. 2000;11:259-74. doi: 10.1177/10454411000110020801.
23. Olatunbosun O, Deneer H, Pierson R. Human papillomavirus DNA detection in sperm using polymerase chain reaction. Obstet Gynecol. 2001;97:357-60. doi: 10.1016/s0029-7844(00)01183-2.
24. Perez-Andino J, Buck CB, Ribbeck K. Adsorption of human papillomavirus 16 to live human sperm. PLoS One. 2009;4:e5847. doi: 10.1371/journal.pone.0005847.
25. Lee SM, Park JS, Norwitz ER, Koo JN, Oh IH, Park JW, et al. Risk of vertical transmission of human papillomavirus throughout pregnancy: a prospective study. PloS One. 2013;8:e66368. doi: 10.1371/journal.pone.0066368.
26. Armbruster-Moraes E, Ioshimoto LM, Leão E, Zugaib M. Presence of human papillomavirus DNA in amniotic fluids of pregnant women with cervical lesions. Gynecol Oncol. 1994;54:152-8. doi: 10.1006/gyno.1994.1185.
27. Yoshida K, Furumoto H, Abe A, Kato T, Nishimura M, Kuwahara A, et al. The possibility of vertical transmission of human papillomavirus through maternal milk. J Obstet Gynaecol. 2011;31:503-6. doi: 10.3109/01443615.2011.570814.
28. Mammas I, Sourvinos G, Giamarelou P, Michael C, Spandidos D. Human papillomavirus in the oral cavity of children and mode of delivery: a retrospective study. Int J STD AIDS. 2012;23:185-8. doi: 10.1258/ijsa.2009.009483.
29. Sarkola M, Rintala M, Grénman S, Syrjänen S. Human papillomavirus DNA detected in breast milk. Pediatr Infect Dis J. 2008;27:557-8. doi: 10.1097/INF.0b013e318169ef47.
30. Mammas IN, Zaravinos A, Sourvinos G, Myriokefalitakis N, Theodoridou M, Spandidos DA. Can ‘high‐risk’human papillomaviruses (HPVs) be detected in human breast milk? Acta Paediatr. 2011;100:705-7. doi: 10.1111/j.1651-2227.2010.02129.x.
31. Diaz S, Boulle N, Molès J-P, Peries M, Rutagwera D, Kankasa C, et al. Human papillomavirus (HPV) shedding in breast milk from African women living with HIV. J Clin Virol. 2018;106:41-3. doi: 10.1016/j.jcv.2018.07.004.
32. Tuominen H, Rautava S, Collado MC, Syrjänen S, Rautava J. HPV infection and bacterial microbiota in breast milk and infant oral mucosa. PLoS One. 2018;13:e0207016. doi: 10.1371/journal.pone.0207016.
33. Louvanto K, Sarkola M, Rintala M, Syrjänen K, Grenman S, Syrjänen S. Breast milk is a potential vehicle for human papillomavirus transmission to oral mucosa of the spouse. Pediatr Infect Dis J. 2017;36:627-30. doi: 10.1097/INF.0000000000001546.
34. Boccardo E. New approaches for infective HPV detection, quantification and inactivation: Preventing accidental virus transmission in medical settings. EBioMedicine. 2021;64:103222. doi: 10.1016/j.ebiom.2021.103222.
35. Egawa N, Shiraz A, Crawford R, Saunders-Wood T, Yarwood J, Rogers M, et al. Dynamics of papillomavirus in vivo disease formation & susceptibility to high-level disinfection—Implications for transmission in clinical settings. EBioMedicine. 2021;63:103177. doi: 10.1016/j.ebiom.2020.103177.
36. Abramowicz JS, Evans DH, Fowlkes JB, Marsal K, terHaar G, Committee WS. Guidelines for Cleaning Transvaginal Ultrasound Transducers Between Patients. Ultrasound Med Biol. 2017;43:1076-9. doi: 10.1016/j.ultrasmedbio.2017.01.002.
37. M'Zali F, Bounizra C, Leroy S, Mekki Y, Quentin-Noury C, Kann M. Persistence of microbial contamination on transvaginal ultrasound probes despite low-level disinfection procedure. PloS One. 2014;9:e93368. doi: 10.1371/journal.pone.0093368.
38. Ozbun MA, Bondu V, Patterson NA, Sterk RT, Waxman AG, Bennett EC, et al. Infectious titres of human papillomaviruses (HPVs) in patient lesions, methodological considerations in evaluating HPV infectivity and implications for the efficacy of high-level disinfectants. EBioMedicine . 2021; 63:103165. doi: 10.1016/j.ebiom.2020.103165.
39. Dong SM, Pai SI, Rha S-H, Hildesheim A, Kurman RJ, Schwartz PE, et al. Detection and quantitation of human papillomavirus DNA in the plasma of patients with cervical carcinoma. Cancer Epidemiol Biomarkers Prev. 2002;11:3-6.
40. Bodaghi S, Wood LV, Roby G, Ryder C, Steinberg SM, Zheng Z-M. Could human papillomaviruses be spread through blood? Clin Microbiol. 2005;43:5428-34. doi: 10.1128/JCM.43.11.5428-5434.2005.
41. Chen ACH, Keleher A, Kedda MA, Spurdle AB, McMillan NA, Antonsson A. Human papillomavirus DNA detected in peripheral blood samples from healthy Australian male blood donors. J Med Virol. 2009;81:1792-6. doi: 10.1002/jmv.21592.
42. Vergara N, Balanda M, Vidal D, Roldán F, S. Martín H, Ramírez E. Detection and quantitation of human papillomavirus DNA in peripheral blood mononuclear cells from blood donors. J Med Virol. 2019;91:2009-15. doi: 10.1002/jmv.25551.
43. Gupta I, Nasrallah GK, Sharma A, Jabeen A, Smatti MK, Al-Thawadi HA, et al. Co-prevalence of human Papillomaviruses (HPV) and Epstein–Barr virus (EBV) in healthy blood donors from diverse nationalities in Qatar. Cancer Cell Int. 2020; 22:45. doi: 10.1186/s12935-022-02459-4.
44. Roperto S, Comazzi S, Ciusani E, Paolini F, Borzacchiello G, Esposito I, et al. PBMCs are additional sites of productive infection of bovine papillomavirus type 2. J Gen Virol. 2011;92:1787 -94. doi: 10.1099/vir.0.031740-0.
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Kenarkoohi A. Review of sexual and nonsexual transmission routes of human papillomavirus: evidence and challenges. J. Ilam Uni. Med. Sci. 2026; 33 (6) :137-148
URL: http://sjimu.medilam.ac.ir/article-1-8778-en.html


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Volume 33, Issue 6 (1-2026) Back to browse issues page
مجله دانشگاه علوم پزشکی ایلام Journal of Ilam University of Medical Sciences
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