Revista do Instituto de Medicina Tropical de São Paulo (Aug 2021)

Recurrent respiratory papillomatosis: clinical characteristics and viral genotyping in a Brazilian population

  • Ana Maria Almeida Silva Carvalho,
  • Danielle Salgado de Brito,
  • Ana Paula Almeida Cunha,
  • Pablo de Matos Monteiro,
  • Mariele Borges Ferreira,
  • Diogo Souza Ferreira Rubim de Assis,
  • Janaína Oliveira Bentivi,
  • Marcelo Souza de Andrade,
  • Flávia Castello Branco Vidal,
  • Natalino Salgado Filho

DOI
https://doi.org/10.1590/s1678-9946202163063
Journal volume & issue
Vol. 63

Abstract

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ABSTRACT This study presents 25 cases of recurrent respiratory papillomatosis (RRP) that occurred in Sao Luis, Maranhao State, Northeast region, Brazil, between January 2007 and December 2018. Sociodemographic and clinical profile of patients as well as human papillomavirus (HPV) infection status were evaluated. Clinical and histopathological data were collected from the patients’ medical records. For the HPV infection analysis, DNA was extracted and subjected to amplification by a nested polymerase chain reaction. Viral genotyping was performed by automated sequencing. The median age of patients was 12.40 ± 12.6. years, and the juvenile form of the disease (68%) was the predominant form of disease. Female participants were predominant (60%), and they were from cities located in the interior of the State (60%). The most common clinical manifestation was dysphonia; recurrence was observed in most cases (56%), and tracheostomy was necessary in seven patients (26.9%). When comparing the RRP forms, patients in the juvenile-RRP group had higher recurrence rates and need of tracheostomy than those in the adult-RRP group. The viral genotyping analysis revealed that 47.8% of patients had low-risk HPVs, whereas 13.1% had high-risk HPVs, and in 39.1% of patients the viral genotype was not obtained. HPV-6 was the most prevalent type and Juvenile-RRP was more prevalent in our population. HPV was present at a high rate, and HPV-6 was the predominant genotype. This study serves as the basis for further studies to be conducted in the Brazilian population. Our findings aid the better understanding of RRP, possibly suggesting some prognostic factors associated with the disease aggressiveness.

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