Juvenile-and adult-onset laryngeal papillomas were examined for the presence of a human papillomavirus (HPV) genome and capsid antigens. DNA was isolated from a portion of tissue removed for therapeutic purposes, and the presence of a papillomavirus genome was detected by Southern transfer analysis. The viral DNA found in the 12 juvenile-onset and the 8 adultonset laryngeal papillomas examined was identified as HPV-6 on the basis of size, restriction endonuclease digestion patterns, and homology detected under stringent conditions. Restriction endonuclease analysis of the viral genomes revealed at least four different subtypes, designated HPV-6c through HPV-6f. The most common subtype, HPV-6c, was detected in over half of the papillomas studied, including both juvenile and adult types. The remaining tissue was fixed and processed for immunocytochemistry. The immunoperoxidase technique was used with an antiserum that reacts with capsid antigen(s) common to all HPV serotypes. HPV antigen was found in two of the juvenile-onset papillomas and two of the adult-onset papillomas. The antigen was localized to the nucleus and was distributed in the superficial layers of the epithelium. HPV capsid antigen had not previously been detected in cases of adult-onset papilloma, and the HPV genome in both juvenile-and adult-onset laryngeal papillomas had not been characterized. Despite the absence of detectable viral antigen in most of the specimens examined, the presence of the HPV genome provides strong evidence for the papillomavirus etiology of these tumors.Squamous papillomas ofthe larynx are a serious clinical problem because of their location, their resistance to treatment, their relentless recurrence, and their tendency to spread throughout the respiratory tract (1, 2). The most frequent age of onset is in the first five years oflife, but the disease also occurs in adults.Papillomas of the larynx are tumors of lobulated or papillary form in which each projection has a central core of connective tissue covered with squamous epithelium (3). They histologically resemble cutaneous warts, whose papillomavirus etiology has been established (for review, see ref. 4). Although a papillomavirus etiology has been implicated for laryngeal papillomas, there have been conflicting reports on the presence of virus particles in these tumors when examined by electron microscopy (5-8). More recently, papillomavirus capsid antigen has been detected in juvenile-onset laryngeal papillomas by the immunoperoxidase technique of Sternberger (9), using an antiserum that reacts with genus-specific antigens (10-12). In these studies, papillomavirus antigen was detected in less than half ofthe juvenile-onset laryngeal papillomas. In the positive cases it was not possible to identify the specific viral serotype present in the lesions because the antiserum is crossreactive with capsid antigens of all papillomaviruses. Despite attempts to isolate papillomavirus or detect the papillomavirus genome in juvenile-onset laryngeal papillomas (13-17), ...