HN 10-03AN EVALUATION OF RRP RISK FACTORS: IS IT AGE OF DIAGNOSIS OR HPV TYPE?

Recurrent respiratory papillomatosis is a rare but potentially devastating disease caused by two “low risk” HPV types better known for causing genital warts. The epidemiologic risk factors are well described but only account for incidence. The disease course that each person follows is variable. Some run an indolent course while those who either 1) undergo 10 or more procedures for RRP or 2) undergo 4 or more surgeries within a 12 month period or 3) develop disease distal to the larynx or 4) undergo a tracheotomy are considered to have aggressive disease. Ever since an association between aggressive recurrent respiratory papillomatosis and HPV 11 was discovered, clinicians have wanted to obtain HPV typing as part of their workup. What information would HPV typing provide and how much of the variability could be predicted if typing was known?

Together, we will review past data sets showing that young age of onset, HPV 11 and aggressive course are all associated. Then we will use multiple regression and Fast and Frugal Trees to determine the utility of HPV type to predict aggressiveness.

From our largest data set presented at HPV 2017 in Cape Town, 338 subjects with ≥ 1 year follow up and with a single HPV type were classified.

In multiple logistic regression, aggressiveness was associated with JoRRP but not with HPV type.

In multiple analyses we observe that young age of disease diagnosis is far more closely associated with aggressiveness than is HPV type.