Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town
Background: Juvenile onset recurrent respiratory papillomatosis (JoRRP) is an incurable condition caused by human papilloma virus (HPV) types 6 and 11, often requiring repeated surgeries and in severe cases, tracheostomy. This imposes a significant socioeconomic burden on patients and families. Gard...
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2024-05-01
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| Series: | Journal of the Colleges of Medicine of South Africa |
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| Online Access: | https://jcmsa.org.za/index.php/jcmsa/article/view/33 |
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| author | Shavina Frank Jessica K. McGuire Fiona Kabagenyi Vincent Pretorius Shazia Peer |
| author_facet | Shavina Frank Jessica K. McGuire Fiona Kabagenyi Vincent Pretorius Shazia Peer |
| author_sort | Shavina Frank |
| collection | DOAJ |
| description | Background: Juvenile onset recurrent respiratory papillomatosis (JoRRP) is an incurable condition caused by human papilloma virus (HPV) types 6 and 11, often requiring repeated surgeries and in severe cases, tracheostomy. This imposes a significant socioeconomic burden on patients and families. Gardasil®, a proven prophylactic HPV vaccine, is emerging as a potential adjuvant therapy. We studied its response on JoRRP patients at our center.
Methods: We conducted a retrospective review at Red Cross War Memorial Children’s Hospital from January 2015 to June 2022 on histologically confirmed JoRRP cases. Age at diagnosis, baseline and post-dosing Derkay-Coltrera (DC) scores (disease severity measure), inter-surgical intervals and tracheostomy, were collected.
Results: Twenty-five of 30 confirmed cases were included. Average age at diagnosis was 60 months (about 5 years old), with HPV Type 6 in 40% and Type 11 in 48% of patients. All patients received at least one Gardasil® dose, 84% received a second dose and 64% a third dose. Total population DC score decreased from an average of 17 (range: 4-34) pre-first dose to 8 (range: 0-16) after three doses, indicating a 50% reduction. Surgical intervals modestly increased. More significant improvements were seen in patients with aggressive forms of the disease.
Conclusion: This is the first study in Southern Africa highlighting Gardasil® as adjuvant therapy. Despite our limited sample size, new cases observed a linear reduction in DC scores and tracheostomy rates.
Contribution: This suggests that Gardasil® as adjuvant therapy has the potential to reduce disease severity and extend surgical intervals. |
| format | Article |
| id | doaj-art-16f9859919f841b2a42edbe4ccdaf880 |
| institution | OA Journals |
| issn | 2960-110X |
| language | English |
| publishDate | 2024-05-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Journal of the Colleges of Medicine of South Africa |
| spelling | doaj-art-16f9859919f841b2a42edbe4ccdaf8802025-08-20T02:02:15ZengAOSISJournal of the Colleges of Medicine of South Africa2960-110X2024-05-0121e1e410.4102/jcmsa.v2i1.3319Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape TownShavina Frank0Jessica K. McGuire1Fiona Kabagenyi2Vincent Pretorius3Shazia Peer4Division of Otorhinolaryngology, Department of Surgery, Faculty of Health Sciences, University of Cape Town (Red Cross War Memorial Children’s Hospital), Cape TownDivision of Otorhinolaryngology, Department of Surgery, Faculty of Health Sciences, University of Cape Town (Red Cross War Memorial Children’s Hospital), Cape TownDepartment of Ear Nose and Throat, Faculty of Medicine, Makerere University, KampalaDivision of Otorhinolaryngology, Department of Surgery, Faculty of Health Sciences, University of Cape Town (Red Cross War Memorial Children’s Hospital), Cape TownDivision of Otorhinolaryngology, Department of Surgery, Faculty of Health Sciences, University of Cape Town (Red Cross War Memorial Children’s Hospital), Cape TownBackground: Juvenile onset recurrent respiratory papillomatosis (JoRRP) is an incurable condition caused by human papilloma virus (HPV) types 6 and 11, often requiring repeated surgeries and in severe cases, tracheostomy. This imposes a significant socioeconomic burden on patients and families. Gardasil®, a proven prophylactic HPV vaccine, is emerging as a potential adjuvant therapy. We studied its response on JoRRP patients at our center. Methods: We conducted a retrospective review at Red Cross War Memorial Children’s Hospital from January 2015 to June 2022 on histologically confirmed JoRRP cases. Age at diagnosis, baseline and post-dosing Derkay-Coltrera (DC) scores (disease severity measure), inter-surgical intervals and tracheostomy, were collected. Results: Twenty-five of 30 confirmed cases were included. Average age at diagnosis was 60 months (about 5 years old), with HPV Type 6 in 40% and Type 11 in 48% of patients. All patients received at least one Gardasil® dose, 84% received a second dose and 64% a third dose. Total population DC score decreased from an average of 17 (range: 4-34) pre-first dose to 8 (range: 0-16) after three doses, indicating a 50% reduction. Surgical intervals modestly increased. More significant improvements were seen in patients with aggressive forms of the disease. Conclusion: This is the first study in Southern Africa highlighting Gardasil® as adjuvant therapy. Despite our limited sample size, new cases observed a linear reduction in DC scores and tracheostomy rates. Contribution: This suggests that Gardasil® as adjuvant therapy has the potential to reduce disease severity and extend surgical intervals.https://jcmsa.org.za/index.php/jcmsa/article/view/33gardasil-4gardasil-4®juvenile-onset recurrent respiratory papillomavaccineupper airway obstructiontracheostomyderkay-coltrera scorehuman papilloma virus |
| spellingShingle | Shavina Frank Jessica K. McGuire Fiona Kabagenyi Vincent Pretorius Shazia Peer Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town Journal of the Colleges of Medicine of South Africa gardasil-4 gardasil-4® juvenile-onset recurrent respiratory papilloma vaccine upper airway obstruction tracheostomy derkay-coltrera score human papilloma virus |
| title | Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town |
| title_full | Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town |
| title_fullStr | Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town |
| title_full_unstemmed | Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town |
| title_short | Gardasil® as adjunctive therapy for respiratory papillomatosis at Red Cross Children’s Hospital, Cape Town |
| title_sort | gardasil r as adjunctive therapy for respiratory papillomatosis at red cross children s hospital cape town |
| topic | gardasil-4 gardasil-4® juvenile-onset recurrent respiratory papilloma vaccine upper airway obstruction tracheostomy derkay-coltrera score human papilloma virus |
| url | https://jcmsa.org.za/index.php/jcmsa/article/view/33 |
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