Human Papillomavirus

Biography

Biography: Gerardo C Palacios

Abstract

Objective: To evaluate the clinical characteristics, presence and severity of laryngeal dysplasia and human papilloma virus (HPV) genotypes in patients with juvenile-onset recurrent respiratory papillomatosis (JORRP) in a tertiary care facility in Northeastern Mexico. Design: A prospective observational study in patients with JORRP who underwent biopsy by suspension microlaryngoscopy. Setting: A single tertiary care unit with pediatric and adult otolaryngology services in Northeastern Mexico. Participants: Thirty patients with JORRP. Main outcome measures: Clinical data, number of surgical resections, presence and severity of dysplasia, and HPV genotypes as determined by the reverse linear hybridization INNO-LiPA assay. Results: Median age at presentation was 3.5 years (range 8 months to 17 years), 22 patients were females (73.3%) and 8 males (26.7%). The main symptom was dysphonia (53.3%) and the total number of resections per patient ranged 2 to 550 (median 15.5). Dysplasia was identified in 13 patients (43.4%). The most frequent genotypes were HPV-11 (40%) and HPV-6 (36.7%). Co-infection with two or three genotypes was detected in seven patients (23.3%), including the genotype HPV-16 in four of them (10%). Conclusions: Patients with JORRP experienced a significant delay in establishing the diagnosis, required multiple surgical resections, and had a high rate of laryngeal dysplasia. The most common HPV genotypes were 11 and 6, followed by HPV-16. This is the first study in Mexico evaluating clinical characteristics, dysplasia severity and HPV genotypes in patients with JORRP.