Media Releases

Impact of HPV infection of the airway measured for the first time

July 7, 2010

TORONTO – For the first time, the scope and dev­as­tat­ing impact of the human papil­lo­ma virus (HPV) infec­tion of the air­way in chil­dren has been mea­sured, accord­ing to a new pop­u­la­tion study from the Uni­ver­si­ty of Toron­to and The Hos­pi­tal for Sick Chil­dren (Sick­Kids).

For some time, the impact of HPV infec­tion on the cer­vi­cal and anogen­i­tal tract (anus and gen­i­tal tract) has been wide­ly rec­og­nized; less well doc­u­ment­ed is the impact of the same afflic­tion in the air­way. The dis­ease, which can be passed from infect­ed moth­er to child dur­ing preg­nan­cy or child­birth, can cause wart-like lesions of the nose, phar­ynx, tra­chea and bronchi. These lesions inter­fere with breath­ing and require fre­quent sur­gi­cal removal. In chil­dren, the afflic­tion is known as juve­nile onset recur­rent res­pi­ra­to­ry papil­lo­mato­sis, or JoR­RP.

For a rel­a­tive­ly rare dis­ease, JoR­RP extracts a sig­nif­i­cant toll on patients, fam­i­lies and the health-care sys­tem, accord­ing to a study by Pao­lo Camp­isi, Asso­ciate Pro­fes­sor in the Uni­ver­si­ty of Toron­to Temer­ty Temer­ty Fac­ul­ty of Medicine’s Depart­ment of Oto­laryn­gol­o­gy – Head & Neck Surgery and Staff Oto­laryn­gol­o­gist and Project Inves­ti­ga­tor at Sick­Kids. The study, pub­lished in the June advance online edi­tion of the peer-reviewed jour­nal Laryn­goscopy, was pre­sent­ed by Camp­isi at the 26^th Inter­na­tion­al Papil­lo­ma Virus & Clin­i­cal and Pub­lic Health Work­shops con­fer­ence in Mon­tre­al last week.

“While the over­all inci­dence of JoR­RP is low, the impli­ca­tion for the afflict­ed chil­dren is sig­nif­i­cant and know­ing the scope of the prob­lem is crit­i­cal. There is an enor­mous phys­i­cal, psy­cho­log­i­cal and finan­cial bur­den for these young patients and their fam­i­lies,” said Dr. Camp­isi, who is also Direc­tor of Sick­Kids’ Cen­tre for Pae­di­atric Voice and Laryn­geal Func­tion.

Dr. Camp­isi and his team col­lect­ed data from col­leagues across Cana­da and found that between 1994 and 2007, the over­all inci­dence rate of JoR­RP in chil­dren aged 14 and younger was only 0.24 cas­es per 100,000, or 243 report­ed cas­es (the preva­lence rate was 1.11 per 100,000). But that mod­est num­ber of cas­es required a sub­stan­tial 3,021 sur­gi­cal pro­ce­dures per­formed on affect­ed chil­dren. The data revealed that the medi­an age at time of diag­no­sis was 4.4 years, and chil­dren with JoR­RP under­went a medi­an of sev­en sur­gi­cal pro­ce­dures each.

Patients were near­ly equal­ly split between male and female. The data­base also showed region­al vari­a­tions with­in Cana­da. Over the course of the study peri­od, the dis­ease preva­lence rose in Atlantic Cana­da and Que­bec, decreased in Ontario and British Colum­bia and held steady in the Prairies.

“Gen­i­tal HPV infec­tion is the most com­mon sex­u­al­ly trans­mit­ted dis­ease among young, sex­u­al­ly active peo­ple. Wide­spread vac­ci­na­tion against HPV with­in the female pop­u­la­tion may affect the inci­dence of JoR­RP and spare chil­dren from the harsh con­se­quences of the dis­ease,” Dr. Camp­isi said.

Despite being a rare con­di­tion, esti­mates have put the cost of treat­ment in the U.S. at $100 mil­lion annu­al­ly. While the inci­dence and preva­lence of JoR­RP has been exam­ined in some parts of the world, the major­i­ty of the report­ed epi­demi­o­log­i­cal rates are derived from lim­it­ed pop­u­la­tions or from esti­mates and extrap­o­la­tions. Dr. Campisi’s data­base is the first well-defined pop­u­la­tion study of JoR­RP. Canada’s pub­lic health-care sys­tem and pop­u­la­tion size made it an ide­al sub­ject for a study of this kind, he said. The nation­al data­base will also be used as the basis for future sur­veil­lance stud­ies and to facil­i­tate recruit­ment for inter­ven­tion­al tri­als.

This study was fund­ed, in part, by an unre­strict­ed research grant from Mer­ck Frosst Cana­da Ltd. and by Sick­Kids Foun­da­tion.

About the Uni­ver­si­ty of Toron­to

Estab­lished in 1827, the Uni­ver­si­ty of Toron­to has one of the strongest research and teach­ing fac­ul­ties in North Amer­i­ca, pre­sent­ing top stu­dents at all lev­els with an intel­lec­tu­al envi­ron­ment unmatched in depth and breadth on any oth­er Cana­di­an cam­pus.  With more than 75,000 stu­dents across three cam­pus­es (St. George, Mis­sis­sauga and Scar­bor­ough) and over 450,000 alum­ni active in every region of the world, U of T’s influ­ence is felt in every area of human endeav­our. www.utoronto.ca

About The Hos­pi­tal for Sick Chil­dren (Sick­Kids)

The Hos­pi­tal for Sick Chil­dren (Sick­Kids) is rec­og­nized as one of the world’s fore­most pae­di­atric health-care insti­tu­tions and is Canada’s lead­ing cen­tre ded­i­cat­ed to advanc­ing children’s health through the inte­gra­tion of patient care, research and edu­ca­tion. Found­ed in 1875 and affil­i­at­ed with the Uni­ver­si­ty of Toron­to, Sick­Kids is one of Canada’s most research-inten­sive hos­pi­tals and has gen­er­at­ed dis­cov­er­ies that have helped chil­dren glob­al­ly.  Its mis­sion is to pro­vide the best in com­plex and spe­cial­ized fam­i­ly-cen­tred care; pio­neer sci­en­tif­ic and clin­i­cal advance­ments; share exper­tise; fos­ter an aca­d­e­m­ic envi­ron­ment that nur­tures health-care pro­fes­sion­als; and cham­pi­on an acces­si­ble, com­pre­hen­sive and sus­tain­able child health sys­tem.  Sick­Kids is proud of its vision of Health­i­er Chil­dren. A Bet­ter World.™ For more infor­ma­tion, please vis­it www.sickkids.ca. 

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For more infor­ma­tion:

Matet Nebres
The Hos­pi­tal for Sick Chil­dren
416–813-6380
matet.nebres@sickkids.ca

Suzanne Gold
The Hos­pi­tal for Sick Chil­dren
416–813-7654, ext. 2059
suzanne.gold@sickkids.ca

Paul Can­tin
Uni­ver­si­ty of Toron­to Temer­ty Temer­ty Fac­ul­ty of Med­i­cine
416–978-2890
paul.cantin@utoronto.ca