The role of HPV type in recurrent respiratory papillomatosis

Objective: Human Papillomavirus (HPV) 6 and 11 are the aetiological agents responsible for Recurrent Respiratory Papillomatosis (RRP). There is general consensus that HPV11 results in more aggressive disease compared to HPV6.

Method: Pubmed was searched using the terms respiratory papillomatosis, HPV6 and HPV11. Comparisons were made in the outcomes of HPV6 versus HPV11 positive RRP disease.

Results: There are numerous sub-types or variants of both HPV6 and HPV11. These sub-types have different activities at least in-vitro. The numbers of different HPV types within RRP tissue may be more extensive than initially appeared. This depends specifically upon the HPV types tested for.

Conclusion: The clinical differences between HPV6 and HPV11 disease may not be accurately predictable as these viruses exist in numerous subtypes. Also, RRP tissue may contain more than one subtype or even be co-infected with other viruses that may influence outcome. In-vitro studies upon cell lines are a reasonable starting point for evaluation of these differences.


Recurrent Respiratory Papillomatosis (RRP) is a disease in which squamous wart-like lesions occur within the respiratory tract. It is caused by the so called “low risk” Human Papillomavirus (HPV) types 6 and 11. Contemporary opinion amongst otolaryngologists is that HPV 11 related disease is more aggressive than HPV 6 [1] although this is not universally supported by the published data. If there were HPV type related differences in the severity of RRP, this would indicate that optimum choice of therapy could be dependent on the HPV type that is present. However, this is not a simple problem since the prevalence of HPV in both dormant pre-clinical and clinical conditions is variable and the influence of co-infection with other HPV types has not been fully evaluated. […]