Tuan T. Nguyen
BACKGROUND: Recurrent respiratory papillomatosis (RRP) is a rare airway disease primarily caused by human papillomavirus (HPV), most commonly types 6 and 11, with variable clinical aggressiveness. The relationship between HPV genotypes and disease severity remains underexplored in Southeast Asian populations.METHODS: We conducted a retrospective cohort study at a tertiary referral center in Ho Chi Minh City, Vietnam. Forty patients with histologically confirmed RRP, available HPV genotyping results, and at least 12 months of follow-up after the most recent surgical treatment were included. HPV DNA was detected by polymerase chain reaction and genotyped using reverse dot blot hybridization. Clinical aggressiveness was assessed based on anatomical extent, surgical burden, and 12-month outcomes. A parsimonious logistic regression model was used to assess genotype-specific associations.RESULTS: HPV DNA was detected in 34/40 patients (85%), with HPV11 in 12/40 (30%), HPV6 in 9/40 (22.5%), and HPV16/18 in 6/40 (15%). Diffuse disease and recurrence were more frequent among patients with HPV11 and HPV16/18 than among those with HPV6. Compared with HPV6, HPV11 was associated with a higher risk of aggressive disease (adjusted OR=3.9, 95% CI: 1.2-13.1), as was HPV16/18 (adjusted OR=5.2, 95% CI: 1.5-18.2). One case of malignant transformation was observed in an adult with HPV16 infection.CONCLUSIONS: In this cohort, HPV11 and HPV16/18 were associated with more aggressive short-term clinical features of RRP, including diffuse disease and recurrence. These findings support the potential role of HPV genotyping in early risk stratification, although larger studies with longer follow-up are needed.