Novakovic Daniel, Cheng Alan T L, Cope Daron H, Brotherton Julia M L
St Luke's Roosevelt Hospital, New York, NY 10019, USA.
Sex Health. 2010 Sep;7(3):253-61. doi: 10.1071/SH09142.
Recurrent respiratory papillomatosis (RRP) causes serious morbidity. RRP in Australia may be eliminated in the near future following the implementation of a national vaccination program using a human papillomavirus (HPV) vaccine that protects against infection with HPV types 6 and 11, those responsible for RRP. Baseline data on RRP prevalence and disease burden in Australia are lacking.
Three study methods were used to estimate the burden of juvenile onset RRP in Australia. We conducted a retrospective chart review of RRP cases treated at The Children's Hospital at Westmead over 10 years, examined the coding of these cases, and then calculated and applied the positive predictive value of the codes to national data to estimate the prevalence of RRP in Australia. We also conducted an online survey of otolaryngologists in Australia who manage RRP.
Nineteen patients were treated at the hospital over 10 years, involving 359 admissions. We estimate that between 33 and 56 RRP cases aged <20 are being treated nationally per year (0.6-1.1 per 100 000 persons), with children 5-9 years having a higher estimated rate of 1.2-1.8 per 100 000. Among 39 otolaryngologists treating juvenile onset RRP, the majority (73%) treated RRP in a paediatric tertiary hospital, and used the microdebrider for ablation of lesions.
Our estimates of RRP disease burden agree with international estimates. As a small number of clinicians treat RRP nationally, we believe that establishment of a national RRP register is both feasible and necessary to monitor the impact of vaccination.
复发性呼吸道乳头状瘤病（RRP）会导致严重的发病情况。在澳大利亚实施一项使用人乳头瘤病毒（HPV）疫苗的全国性疫苗接种计划后，RRP在不久的将来可能会被消除，该疫苗可预防导致RRP的6型和11型HPV感染。澳大利亚缺乏关于RRP患病率和疾病负担的基线数据。
采用三种研究方法来估计澳大利亚青少年期RRP的负担。我们对韦斯特米德儿童医院10年间治疗的RRP病例进行了回顾性病历审查，检查了这些病例的编码，然后计算并将编码的阳性预测值应用于全国数据，以估计澳大利亚RRP的患病率。我们还对澳大利亚治疗RRP的耳鼻喉科医生进行了在线调查。
10年间该医院共治疗了19名患者，涉及359次住院。我们估计，全国每年治疗的年龄＜20岁 的RRP病例有33至56例（每10万人中有0.6 - 1.1例），5 - 9岁儿童的估计发病率较高，为每10万人中有1.2 - 1.8例。在39名治疗青少年期RRP的耳鼻喉科医生中，大多数（73%）在儿科三级医院治疗RRP，并使用微型清创器切除病变。
我们对RRP疾病负担的估计与国际估计结果一致。由于全国范围内治疗RRP的临床医生数量较少，我们认为建立一个全国性的RRP登记册对于监测疫苗接种的影响既可行又必要。
