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Published on: March 11, 2014
Human papillomatosis genotyping and severity in patients with recurrent respiratory papillomatosis
Insights
Human papillomavirus (HPV) types 6 and 11 cause recurrent respiratory papillomatosis (RRP) in Thai children. HPV type 11 infection leads to more severe RRP than HPV type 6.
Area of Science:
- Otolaryngology
- Pediatric Oncology
- Virology
Background:
- Recurrent respiratory papillomatosis (RRP) is the most common laryngeal neoplasm in children, caused by human papillomavirus (HPV).
- While rarely fatal, RRP necessitates extensive treatment, causing significant distress to patients and families.
- Previous studies identified HPV types 6 and 11 in Thai RRP patients, but lacked genotype-specific staging and severity data.
Purpose of the Study:
- To identify HPV genotypes in Thai children with RRP.
- To compare disease staging and severity in relation to identified HPV genotypes.
Main Methods:
- Prospective study conducted from January 2011 to January 2013.
- Disease severity was consistently scored during endoscopic evaluations and debridements.
- HPV genotyping was performed on patient samples.
Main Results:
- Fifteen Thai children (7 female, 8 male) were enrolled.
- HPV type 6 caused RRP in 40% and HPV type 11 in 60% of cases; no co-infections were observed.
- HPV type 11 infections were associated with significantly higher disease severity scores (27.44 ± 8.24) compared to HPV type 6 (13.83 ± 9.94) (p=0.013).
Conclusions:
- HPV types 6 and 11 are the causative agents of RRP in Thai children.
- RRP associated with HPV type 11 presents with greater disease severity than that associated with HPV type 6.
- Increased awareness and further research into RRP treatment are crucial for managing this chronic condition.
Background:
Recurrent respiratory papillomatosis (RRP) is caused by human papilloma virus (HPV) and is the most common benign laryngeal neoplasm in children. Although RRP is rarely fatal, the disease requires prolonged, extensive medical and surgical treatment, leading to physical and emotional suffering in affected children and their families. Previous studies show HPV type 11 and type 6 in the lesion of Thai subjects with RRP. There is currently no published data available from Thailand that compares staging and severity with RRP genotypes.
Objective:
To identify the genotypes of human papilloma virus (HPV) isolated from patients with RRP and compare the staging and severity with human papilloma virus genotype.
Material And Method:
This prospective study was designed to assess population characteristics and follow the clinical course of RRP from January 2011 to January 2013. At each endoscopic evaluation or debridement, all surgeons to stage each patient's disease severity used a consistent scoring system. The samples were analyzed for HPV genotype.
Results:
Fifteen Thai children (7 female, 8 male) with respiratory papillomatosis were enrolled. Results showed that HPV type 6 and HPV type 11 caused RRP in 6 (40%) and 9 (60%) of the children, respectively. No co-infection between HPV type 6 and type 11 was found. Overall mean age at diagnosis of patients with RRP was 2.65 ± 0.82 years. The age at diagnosis was significantly different between both HPV genotypes (p = 0.008). The mean disease severity score for HPV type 6 infection was 13.83 ± 9.94, and that of HPV type 11 infection was 27.44 ± 8.24. The mean disease severity score of HPV type 11 infection was significantly higher than that of HPV type 6 infection (p = 0.013).
Conclusion:
HPV type 6 and type 11 caused RRP in Thai children. RRP attributable to infection with HPV type 11 is more aggressive in disease severity and has a shorter life time than HPV type 6 at time of first diagnosis. RRP is an incurable disease that requires long-term medical management. Improved awareness and understanding amongst the Thai population should be promoted to limit the spread of the disease. In addition, further research on the treatment of RRP would benefit patients.
