RRP Serology Study update September 2011

Abstract for presentation at:
27th INTERNATIONAL PAPILLOMAVIRUS CONFERENCE AND CLINICAL WORKSHOP
Berlin, Germany, 17-22 September, 2011

SEROLOGY IN RRP SIMILAR TO PATIENTS WITH GENITAL HPV INFECTION

F Buchinsky, Allegheny General Hospital, Pittsburgh, UNITED STATES
C Derkay, Eastern Virginia Medical School, Norfolk, United States
D Radley, Merck & Co, North Wales, United States
J McClay, University of Texas Southwestern Medical School- , Dallas, United States
C Myer, University of Cincinnati College of Medicine, Cincinnati, United States
R Bastian, Bastian Voice Institute, Downers Grove, United States
K Lollar, University of Missouri Hospital & Clinics, Columbia, United States
D Marino, Merck & Co, North Wales, United States
D Guris, Merck & Co, North Wales, United States

Background: Recurrent respiratory papillomatosis (RRP) is a rare, but devastating, illness caused by HPV 6 and 11. With the advent of a quadrivalent HPV (qHPV) vaccine (HPV 6/11/16/18), it is useful to know if RRP patients develop a serologic response to the viruses

Objective: To assess HPV 6 and 11 antibody levels measured by competitive Luminex Immunoassay (cLIA) among children (age < 11) and adolescents / adults (age > 11) with RRP. Methods: Four institutions (and two support groups) in the USA recruited a cross-sectional convenience sample of RRP patients. Serum samples were tested with cLIA according to protocols used in qHPV vaccine trials. A subject was declared “double negative” if geometric mean titres (GMT) for anti-HPV 6 and anti-HPV 11 antibody were <20 milli Merck units (mMu) and < 16 mMu, respectively. Subjects provided demographic, vaccination and clinical data. HPV typing was not available. Results: Seventeen of 36 (47%) adolescents and adults with active RRP versus 13/16 (81%) children were double negative (p=0.03). The double negative rate for subjects who had surgery >18 months ago was 6/10 (60%). Amongst all seropositives, the titres were similar to that seen amongst PCR positive subjects in the qHPV vaccine trials. There appeared to be no relationship between titres and time since last surgery. Eight subjects reported receiving qHPV vaccine before enrolling (number of doses unknown); they had GMT of 521 mMu for HPV 6 and 235 mMu for HPV 11; one person had anti-HPV 11 titer below detectable levels. Conclusions: Many adults with RRP have no measurable serologic response to HPV 6 or 11 at a rate similar to subjects with genital infection (59% in qHPV vaccine trials). Children with RRP have a higher rate of seronegativity. RRP patients appeared to mount HPV 6 and 11 serologic response to the qHPV vaccine.

Declaration of interest

Farrel Buchinsky – Extramural research funding by Merck & Co.

This site below contains some of the authors’conclusions and comments. In their manuscript, which is to be written, they will also speculate as to the potential significance of the findings.

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