Prevalence of Epstein-Barr virus infection in recurrent respiratory papillomatosis and the influence on disease severity.

Recurrent respiratory papillomatosis (RRP) is characterized by benign papillomatous lesions in the upper airway associated with human papillomavirus infection. It has been proposed that viral coinfections may contribute to an aggressive clinical course of the disease. For this purpose, we investigated the prevalence of Epstein-Barr virus (EBV) infection among 40 RRP patients by polymerase chain reaction assay. EBV DNA was detected in 11 cases and disease severity was observed in 54.5% of EBV-positive patients. No significant association was found between the RRP severity categories and EBV status (P > 0.05). Regardless EBV status, disease severity showed significant association with RRP diagnosis since childhood (P = 0.009). These findings indicate an absence of direct influence of EBV infection on aggressive course of RRP. However, the development of RRP since childhood increase the susceptibility to disease severity.