Human Papillomatosis Genotyping of Children in Thailand

Recurrent respiratory papillomatosis is caused by human papilloma virus and is the most common benign laryngeal neoplasm in children. Although RRP is rarely fatal, the disease requires prolonged, extensive medical and surgical treatment, and causes physical and emotional suffering in affected children and their families. Although recurrent respiratory papillomatosis is a relatively unusual problem, it accounts for significant health are expenditures.The goal of management of RRP is control of the disease, preservation of the voice and prevention of major complication .The purpose of study will identify risk factors for more severe juvenile RRP through prospective evaluation of a pediatric population in Thailand by the employing a protocol that includes staging of disease severity , as well as HPV genotyping.

Objective:

* To identify the genotypes of HPV isolated from Thai RRP patients
* To compare staging and severity with HPV genotypes
* To correlate the following characteristics of the Thai RRP patients with the HPV genotypes

• biopsy (Procedure): excisional biopsy

Primary outcomes

• Human Papillomavirus Genotypes [12 months]: Distribution of Human papillomavirus(HPV) genotypes identified in the biopsy

Secondary outcomes

• Cotreta-Derkay Score [12 months]: We compared disease severity(Cotreta-Derkay score) between groups of children with two different HPV genotypes Coltera and Derkay have evolved a staging system to stage recurrent papillomatous lesions involving the respiratory tract. Coltera-Derkay method of staging : Clinical score: 1. Voice: Normal - 0, Abnormal - 1, Aphonia - 2 2. Stridor: Absent - 0, Present on activity - 1, Present at rest - 2 3. Respiratory distress - None - 0, Mild - 1, Moderate - 2, Severe - 3, Extreme - 4. Anatomical score: For each site - 0 = none, 1=surface lesion, 2= raised lesion, 3=bulky lesion. Total score = Anatomical score + Total clinical score

Sex: All, ages: any to 18 Years

Inclusion Criteria:

* Patients have active laryngeal papillomatosis .
* Patients have developed this infection before the age of 18 years old.

Exclusion Criteria:

* Children whose families do not sign an informed consent to enter into study.
* Children whose families anticipate discontinuing care at a participating institution during the study period.

Participant flow

Outcome results

• Human Papillomavirus Genotypes (Primary), Number, participants: Children With Recurrent Respiratory Papillomatosis 6
• Cotreta-Derkay Score (Secondary), Mean, score: HPV 6 13.83 +/- 9.94; HPV 11 27.44 +/- 8.24 (p 0.013)

Adverse events

Time frame: 12 months

Limitations and caveats: The number of patients participating in this study was low , so additional studies should be conducted to make the research more effective.

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• Pavinee Intakorn, MD, Principal investigator, Queen Sirikit National Institute of Child Health
• Pavinee Intakorn, MD, Principal investigator, Queen Sirikit National of Child Health