Recurrent respiratory papillomatosis – the Manchester experience, 1974–1992

Abstract

A series of 59 patients of all ages with recurrent respiratory papillomatosis (RRP) treated over an 18-year period is presented. A number of these patients were initially diagnosed in childhood but required treatment throughout adult life. The frequency of laser treatment was not related to either disease duration or age at onset. In 28 patients, the HPV type was identified, showing that HPV type 11 was more common in children and ran a more protracted clinical course. The requirement for tracheostomy in this series was small, whereas the incidence of malignant change in adult patients was significant

Human papilloma virus (HPV) infection in children and adolescents

“…The etiology of RRP is the infection of the upper airway with HPV types 6 and 11 [19,20,47,51]. HPV infection is generally the result of perinatal transmission, implying that consideration of sexual abuse is unnecessary in RRP cases [55,68].…”

“…Measures of HPV 6 and HPV 11 viral loads are relatively stable over time in most children with recurrent respiratory papillomatosis [26]. HPV 11 is considered as the most common cause of RRP [19,47]. Children with RRP infected with HPV 11 are prone to develop more aggressive disease than HPV 6 and require more frequent surgical intervention [29,52].…”

“…Children with RRP infected with HPV 11 are prone to develop more aggressive disease than HPV 6 and require more frequent surgical intervention [29,52]. HPV 11 infection is also related to more frequent need for adjuvant therapies, tracheal and pulmonary disease, and tracheostomy [19,47,68].…”

Longitudinal Measures of Human Papillomavirus 6 and 11 Viral Loads and Antibody Response in Children With Recurrent Respiratory Papillomatosis

“…7 In addition, an extended disease course into adulthood was associated with HPV-11 infection among a series of 59 patients in Manchester, England, who were followed up for 18 years. 13 Antibody responses to HPV have not been well studied in subjects with JORRP. In prior studies, only HPV-11 or HPV-6 and HPV-11 coinfection were studied, and in only 1 was response to virallike particles measured, even though they are the most accepted measure of typespecific antibody response.…”

Molecular Identification of 7 Human Papillomavirus Types in Recurrent Respiratory Papillomatosis

“…12,14 By means of polymerase chain reaction, our study allowed the detection of HPV DNA in 100% of the analyzed samples. With the use of the restriction enzyme RsaI, HPV types 6,11,16,31,33,35, and 39 were identified by the different 188-bp fragment cuts. Type 16 was the most common among the 47 cases (33%), and the most frequent sole causal agent (8 cases [17%]), HPV-31 was the least frequent, being present in only 2 cases (4%) and always associated with other HPV types.…”