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Age of child, more than HPV type, is associated with clinical course in recurrent respiratory papillomatosis

Buchinsky, FJ and Donfack, J and Derkay, CS and Choi, SS and Conley, SF and Myer, CM and McClay, JE and Campisi, P and Wiatrak, BJ and Sobol, SE and Schweinfurth, JM and Tsuji, DH and Hu, FZ and Rockette, HE and Ehrlich, GD and Post, JC (2008) Age of child, more than HPV type, is associated with clinical course in recurrent respiratory papillomatosis. PLoS ONE, 3 (5).

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Background: RRP is a devastating disease in which papillomas in the airway cause hoarseness and breathing difficulty. The disease is caused by human papillomavirus (HPV), 6 or 11 and is very variable. Patients undergo multiple surgeries to maintain a patent airway and in order to communicate vocally. Several small studies have been published in which most have noted that HPV 11 is associated with a more aggressive course. Methodology/Principal Findings: Papilloma biopsies were taken from patients undergoing surgical treatment of RRP and were subjected to HPV typing. 118 patients with juvenile-onset RRP with a least 1 year of clinical data and infected with a single HPV type were analyzed. HPV 11 was encountered in 40% of the patients. By our definition, most of the patients in the sample (81%) had run an aggressive course. The odds of a patient with HPV 11 running an aggressive course were 3.9 times higher that that of patients with HPV 6 (Fisher's exact p=0.017). However, clinical course was more closely associated with age of the patient (at diagnosis and at the time of the current surgery) than with HPV type. Patients with HPV 11 were diagnosed at a younger age (2.4y) than were those with HPV 6 (3.4y) (p=0.014). Both by multiple linear regression and by multiple logistics regression HPV type was only weakly associated with metrics of disease course when simultaneously accounting for age. Conclusions/Significance Abstract: The course of RRP is variable and a quarter of the variability can be accounted for by the age of the patient. HPV 11 is more closely associated with a younger age at diagnosis than it is associated with an aggressive clinical course. These data suggest that there are factors other than HPV type and age of the patient that determine disease course. © 2008 Buchinsky et al.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Buchinsky, FJ
Donfack, J
Derkay, CS
Choi, SS
Conley, SF
Myer, CM
McClay, JE
Campisi, P
Wiatrak, BJ
Sobol, SE
Schweinfurth, JM
Tsuji, DH
Hu, FZ
Rockette, HEherbst@pitt.eduHERBST
Ehrlich, GD
Post, JC
ContributionContributors NameEmailPitt UsernameORCID
Date: 28 May 2008
Date Type: Publication
Journal or Publication Title: PLoS ONE
Volume: 3
Number: 5
DOI or Unique Handle: 10.1371/journal.pone.0002263
Schools and Programs: School of Public Health > Biostatistics
Refereed: Yes
PubMed ID: 18509465
Date Deposited: 18 Jul 2012 20:32
Last Modified: 30 Oct 2019 12:55


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