Adult Respiratory Papillomatosis: Human Papillomavirus Type and Viral Coinfections as Predictors of Prognosis

Abstract

Pathologic material and the records of 29 patients with laryngeal papillomatosis were reviewed. The relationship between the type of human papillomavirus (HPV) and the presence of viral coinfections was correlated with clinical outcome. Using polymerase chain reaction, paraffin-embedded specimens were analyzed for the presence of HPV, Epstein-Barr virus (EBV), cytomegalovirus (CMV), and herpes simplex virus (HSV). The HPV type could be identified in 24 patients' specimens. Twenty-one patients were infected with HPV type 6. The other 3 were infected with HPV type 11 or 16. Three patients developed squamous cell carcinoma, of whom 2 had HPV type 11 or 16. We found HSV, EBV, and CMV in 50%, 12.5%, and 0% of specimens, respectively. An aggressive clinical course was observed in 17 patients. Evidence of coinfection with other viruses was identified in 11 (65%) of these patients. In contrast, a benign clinical course was observed in 7 patients, of whom 2 (29%) had viral coinfections. We conclude that the HPV type and the presence of viral coinfections may be predictive of an aggressive clinical course.

Molecular Identification of 7 Human Papillomavirus Types in Recurrent Respiratory Papillomatosis

“…The logistic regression analysis that relates the clinical severity and the single viral types, in combination or all simultaneously, was negative; nevertheless, type 16 showed a relationship near statistical significance (P=.05), in contrast with the other viral types. The high incidence of HPV types 16, 33, 35, and 39, plus those traditionally associated with RRP, 17 identified in this study indicates that it is necessary to carry out a similar study in a clinically healthy control group to obtain the frequency and distribution of the viral types.…”

Incidence and Duration of Cervical Human Papillomavirus 6, 11, 16, and 18 Infections in Young Women: An Evaluation from Multiple Analytic Perspectives

“…HPV infections can lead to cancers and precancers of the cervix (2), anus, penis, vagina and vulva (3,4), anogenital warts (5,6), and recurrent respiratory papillomatosis (7,8), with growing evidence for a role in the pathogenesis of cancers of the head and neck (9). A diagnosis of HPV can lead to distress (10), shame, and anger and negatively affect sexual activity and enjoyment (11).…”

Papilomatose laríngea recorrente: experiência de 10 anos

“…É dita benigna quando a doença está limitada à laringe, com poucas ou nenhuma recorrência. A papilomatose agressiva é definida por múltiplas recorrências, com disseminação para árvore traqueobrônquica, progressão da doença antes da puberdade, atipia epitelial e desenvolvimento de carcinoma de células escamosas 4 . Quanto à etiologia, experimentos clínicos e estudos com microscopia óptica e eletrônica têm sugerido relação da papilomatose laríngea com infecções virais 5,6 .…”