HPV genotype is a prognosticator for recurrence of respiratory papillomatosis in children

Clin Otolaryngol. 2021 Jan;46(1):181-188. doi: 10.1111/coa.13640. Epub 2020 Sep 22.

Abstract

Objectives: This study aimed to compare the prognosis according to age, genotype or human papillomavirus (HPV) variant in patients with recurrent respiratory papillomatosis (RRP).

Design: Non-concurrent cohort.

Participants: Forty one patients with RRP.

Setting: Tertiary referral hospital.

Main outcome measures: Disease severity was defined by the number of surgeries performed, and Derkay score at surgeries, obtained from medical records. HPV was detected and genotyped, and HPV-6 variants were also assessed.

Results: Fifteen (36.58%) individuals belonged to the juvenile RRP group (JoRRP, less than 18 years), while 26 patients (63.41%) were allocated at the adult group (AoRRP, equal or more than 18 years). JoRRP patients needed, in average, a higher number of surgeries to control the disease than AoRRP patients (mean difference: 3.36). Also, JoRRP patients showed a higher Derkay score at each surgery (mean difference: 3.76). There was no significant difference in the number of surgeries when we compared patients infected with HPV-6 or HPV-11, neither in accordance to HPV-6 variants. Patients with HPV-11 presented a higher mean Derkay score at surgery than those with HPV-6 (mean difference: 4.39); when co-variated by age, we observed that this difference occurred only among JoRRP patients (mean difference: 6.15).

Conclusions: Age of onset of RRP has an important impact on number of surgeries to control disease. Patients with JoRRP and HPV-11 tend to present worse Derkay score at each surgery. HPV genotype among adults and HPV-6 variants had no impact on the outcome of the disease.

Keywords: human papillomavirus; outcome; recurrent respiratory papillomatosis; surgery; type; variant.

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Genotype
  • Human papillomavirus 11 / genetics*
  • Human papillomavirus 6 / genetics*
  • Humans
  • Male
  • Middle Aged
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / surgery
  • Papillomavirus Infections / virology*
  • Prognosis
  • Respiratory Tract Infections / diagnosis*
  • Respiratory Tract Infections / surgery
  • Respiratory Tract Infections / virology*
  • Young Adult

Supplementary concepts

  • Recurrent respiratory papillomatosis