Human Papilloma Virus Genotypes in Recurrent Respiratory Papillomatosis Patients at Kenyatta National Hospital

Abstract

Background: Recurrent Respiratory Papillomatosis is an aggressive, recurrent, difficult to manage disease, caused by Human Papillomavirus. It affects both children and adults. Determination of the human papilloma virus genotype is of prognostic value in management of recurrent respiratory papillomatosis. Objective: To determine human papilloma virus genotypes and correlate with severity of disease in patients with recurrent respiratory papillomatosis at Kenyatta National Hospital. Study design: Hospital based cross-sectional study Study site: The study was conducted at Kenyatta National Hospital Ear, Nose and Throat department, operating theatre and University of Nairobi Kenya Aids Vaccine Initiativeinstitute of clinical research laboratory. Study Population: Patients diagnosed with recurrent respiratory papillomatosis. Methodology: Forty patients diagnosed with recurrent respiratory papillomatosis were recruited. Patients history was taken. Two biopsy samples were taken, one for Human papillomavirus genotyping and the other for histopathology. Disease severity was classified as aggressive or non-aggressive using Doyle criteria. Data analysis: SPSS version 23.0 statistical software was used to analyze data. Descriptive analysis was performed on all variables and summarized into frequency, tables and charts. Pearson chi square was used to test association between independent variables. Results: There were 25(62.5%) male and 15(37.5%) female patients. HPV 6 was isolated in 67.5% patients and HPV 11 in 32.5% with no co-infection. The patients had an age range between 3 to 66 years where majority (92.5%) had JORRP and 7.5 % had AORRP. 40% had aggressive disease while 60% had non-aggressive disease. HPV 11 was found in 81.3% of patients with aggressive disease and HPV 6 in 18.8%. There was a positive correlation between HPV 11 and disease aggression (p<0.001). Conclusion: HPV 6 is the most common (67.5%) HPV genotype in patients with RRP at KNH and HPV 11 is associated with aggressive disease.