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ASSOCIATION BETWEEN HPV GENOTYPES AND DISEASE SEVERITY AND POST-TREATMENT COURSE IN LARYNGEAL PAPILLOMATOSIS AT HO CHI MINH CITY EAR NOSE THROAT HOSPITAL
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Abstract
Background: Laryngeal papillomatosis is a benign lesion caused by hyperplasia of squamous cells forming papillary projections on the surface of the respiratory epithelium, characterized by frequent recurrence and significant impact on the airway, voice quality, and overall quality of life. Objective: To investigate the association between HPV genotypes and clinical severity, disease pattern, and 12-month post-treatment outcomes in patients with laryngeal papillomatosis. Methods: A prospective case series including 40 patients diagnosed and followed at Ho Chi Minh City ENT Hospital, stratified into pediatric (<16 years) and adult (≥16 years) groups. Diagnosis was confirmed by histopathology. HPV detection and genotyping were performed using real-time PCR and/or reverse dot blot hybridization. Key outcomes included dyspnea grade, endoscopic pattern (focal/diffuse), post-treatment course (remission, recurrence, malignant transformation), and treatment-related sequelae. Results: HPV was detected in 77.5% of cases—89.5% in children and 66.7% in adults. HPV11 was the predominant genotype in both age groups, with frequent co-infections. In children, HPV11 was associated with higher rates of grade 1–2 dyspnea and diffuse lesions. In adults, diffuse pattern was significantly associated with HPV11 and HPV16/18 (p<0.01, OR=9, 95% CI: 1.1–217). After 12 months, recurrence was highest in HPV11 (64.7% in children, 24.4% in adults); malignant transformation was observed in HPV-negative (7.3%) and HPV11-positive adults (2.4%). Most sequelae (e.g., anterior commissure webbing, airway stenosis) were linked to HPV11. Conclusion: HPV11 is the dominant genotype and correlates with more severe disease and higher recurrence, especially in children. Malignant transformation was observed mainly in HPV-negative adults. HPV genotyping is clinically valuable for risk stratification and guiding follow-up.
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Keywords
laryngeal papillomatosis, HPV, recurrence, diffuse disease
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