HPV types causing juvenile recurrent laryngeal papillomatosis in South Africa.
OBJECTIVE
To identify human papillomavirus (HPV) types associated with juvenile onset recurrent laryngeal papillomatosis (RLP) in southern Africa, to determine if there is a correlation between HPV type and disease aggressiveness and to determine the diagnostic and prognostic value of rapid molecular techniques for detection and typing of HPV using laryngeal biopsies.


METHODS
Laryngeal biopsies from patients undergoing surgery for RLP were screened for HPV using conventional and real-time PCR techniques. Amplicons were sequenced to determine the HPV type involved. Clinical features were correlated with HPV type.


RESULTS
HPV was identified in papillomata from 18 out of 19 patients. Only HPV-6 and HPV-11 were identified, with no co-infections. There was 100% concordance between conventional and real-time PCR techniques. Patients with HPV-11 disease required more procedures and tended to have higher Derkay scores than those with HPV-6 disease. The HPV types identified in our patients were genetically similar to HPV types from geographically distinct regions.


CONCLUSIONS
RLP in our patient population appears to be exclusively due to HPV-6 or HPV-11. HPV-11 disease appears to be more aggressive than HPV-6 disease. Identification of the HPV types provides motivation for inclusion of vaccines against these types in vaccination programs to protect women against infection and subsequently reduce the incidence of RLP.
Seedat
R Y
RY
Department of Otorhinolaryngology, Universitas Academic Hospital and University of the Free State, Bloemfontein, South Africa.
Thukane
M
M
Jansen
A C
AC
Rossouw
I
I
Goedhals
D
D
Burt
F J
FJ
D000293:Adolescent; D017668:Age of Onset; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D005260:Female; D052140:Human papillomavirus 11 / Q000302:isolation & purification*; D052163:Human papillomavirus 6 / Q000302:isolation & purification*; D006801:Humans; D007223:Infant; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000821:virology*; D008297:Male; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D010212:Papilloma / Q000453:epidemiology / Q000473:pathology* / Q000821:virology*; D027383:Papillomaviridae / Q000145:classification*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D016133:Polymerase Chain Reaction; D012720:Severity of Illness Index; D013019:South Africa / Q000453:epidemiology
D053918:Papillomavirus Vaccines