HUMAN PAPILLOMAVIRUS INFECTION IN PAPILLOMAS AND NONDISEASED RESPIRATORY SITES OF PATIENTS WITH RECURRENT RESPIRATORY PAPILLOMATOSIS USING THE POLYMERASE CHAIN-REACTION

We examined human papillomavirus (HPV) infection in biopsy specimens a nd cellular scrapes that were taken from respiratory papillomas and si x nondiseased sites from the respiratory tract of seven patients. Huma n papillomavirus was detected by polymerase chain reaction amplificati on, followed by DNA hybridization with probes for specific HPV types. All papillomas (1 00.0%, n=5) were positive only for HPV type 6 or 11. In the nondiseased site specimens, 61.3% (19/31) of the specimens wer e positive, again only for HPV type 6 or 11. Among the nondiseased sit e specimens from the cervical trachea, intrathoracic trachea, and bron chus, 80% to 100% were HPV positive compared with only 25% to 50% of H PV infection detected in the nasopharynx, posterior tonsillar pillar, and aryepiglottic fold. These results support the tenet that HPV infec tion is present in clinically normal respiratory tract tissue and that the reservoir site of reinfection is more commonly in the lower airwa y. However, patients with upper-airway involvement were more likely to be diagnosed as having severe disease.