Age at diagnosis, but not HPV type, is strongly associated with clinical course in recurrent respiratory papillomatosis

• DOI: 10.1371/journal.pone.0216697
• Publication Date: 2019-06-13T17:31:02Z
• Authors: Farrel J. Buchinsky; William L. Valentino; Nicole Ruszkay; Evan Powell; Craig S. Derkay; Riaz Y. Seedat; Virgilijus Uloza; Frederik G. Dikkers; David E. Tunkel; Sukgi S. Choi; Anthony J. Mortel...; Paolo Campisi; Juan C. Ospina; Adam J. Donne; Robert T. Sataloff; Stephen F. Conley; John E. McClay; Ellen M. Friedman; Lisa Elden; Dale A. Tylor; Clark A. Rosen; Libby J. Smith; Graeme J. Copley; David E. Karas; John M. Schweinfurth; Charles M. Myer; Brian J. Wiatrak; Joseph E. Dohar; Steven E. Sobol; Robert W. Bastian; Richard J. H. Smith; Marshall E. Smith; Abebe M. Wassie; James C. Post; Garth D. Ehrlich
• Keywords: Recurrent Respiratory Papillomatosis

Background Recurrent Respiratory Papillomatosis (RRP) is a rare disease characterized by the growth of papillomas in airway and especially larynx. The clinical course highly variable among individuals there poor understanding factors that drive an aggressive vs indolent course. Methods A convenience cohort 339 affected subjects with positive for only HPV6 or HPV11 data available 1 year more, from large multicenter international study were included. Exploratory analysis was conducted followed inferential analyses frequentist Bayesian statistics. Results We examined subjects: 82% diagnosed prior to age 18 years, 65% infected HPV6, 69% had When comparing at diagnosis course, probability aggressiveness high children under five years then drops rapidly. For patients after 10 more common. After accounting confounding between young age, HPV type minimally associated aggressiveness. Fast Frugal Trees (FFTs) utilized determine which algorithms yield highest accuracy classify as having consistently created branch diagnostic ~5 old. There no reliable strong association socioeconomic parental factors. Conclusion In largest its type, we have identified critical demarcates less