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Recurrent Respiratory Papillomatosis (RRP)
RRP is usually caused by HPV types 6 and 11, types that also cause the better known condition of genital warts (see below). Rather than infecting genital tissue, the papillomas in RRP occur in the epithelial tissue located in the larynx and airways. Because of their location and size, these papillomas can interfere with breathing in pediatric patients and can occasionally be fatal. Death can occur from airway obstruction, cancerous transformation, the overwhelming spread of the disease or complications from surgical treatments. There are two groups of RRP patients. Juvenile-onset RRP can occur in children born to mothers infected with HPV. Adult-onset RRP may arise from birth or oral sexual activity.
Over 2,300 new cases of pediatric RRP and over 3,600 new cases of adult RRP were diagnosed in a 12-month period according to the most recent reported survey of U.S. otolaryngologists and bronchoesophagologists. The survey estimated that there were over 5,970 cases of active pediatric RRP for which surgery was required in the previous three years, and over 9,000 cases of active adult RRP in the U.S. Approximately 75 percent of diagnosed juvenile-onset cases become evident before the age of five.
No drugs are currently approved for the treatment of RRP in the U.S. Instead, patients are typically treated with surgery under general anesthesia using a microdebrider or a laser. Surgery is not a cure and recurrence is frequent. The average pediatric patient has approximately five surgeries per year, with some patients undergoing more than 20 procedures annually. Each surgery can cost thousands of dollars and result in complications, including the formation of scar tissue, decreased functioning of the larynx, hoarseness and reduced quality of life.
Serious HPV-related diseases
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