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<p>Recurrent respiratory papillomatosis (RRP) is a chronic disease caused by human papillomavirus (HPV) types 6 and 11, often requiring repeated surgical interventions. Recent evidence suggests that adjuvant HPV vaccination may help reduce disease recurrence, but real-world data remain limited.This study aimed to evaluate the impact of quadrivalent HPV vaccine (Gardasil) as an adjuvant treatment on the recurrence burden in RRP patients under routine clinical care.We conducted a retrospective, single-center, within-subject pre–post study including 12 patients with histologically confirmed RRP who received adjuvant Gardasil vaccination. Each patient served as his or her own control. Recurrence outcomes during the 12 months before the first vaccine dose were compared with those during the 12 months after vaccination. The primary outcome was recurrence burden, defined as the number of clinically significant recurrences requiring surgical intervention. Secondary outcomes included recurrence rate per person-year, time to first post-vaccination recurrence, recurrence-free proportion at 12 months, and endoscopic status at follow-up. The total number of recurrences decreased from 25 in the pre-vaccination period to 10 in the post-vaccination period, corresponding to a 60.0% relative reduction. Mean recurrences per patient declined from 2.08 ± 1.00 to 0.83 ± 0.83, and the post-/pre-vaccination recurrence rate ratio was 0.40 (95% CI, 0.19–0.83; <i>p</i> = 0.0005). Five of 12 patients (41.7%) remained recurrence-free at 12 months after vaccination. Among patients who recurred, the median time to first post-vaccination recurrence was 4.5 months, while the estimated median recurrence-free survival for the whole cohort was 6.0 months. At the end of follow-up, 8 of 12 patients (66.7%) had no visible papillomas on endoscopic examination. No vaccine-related adverse events were observed. Adjuvant HPV vaccination was associated with a reduction in recurrence and increased recurrence-free survival in RRP patients in real-world settings. These findings support the potential therapeutic role of HPV vaccination as an adjunct to surgical treatment. Further large-scale studies are warranted to confirm these results.</p>

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Real-world Adjuvant HPV Vaccination (Gardasil) and Recurrence Burden in Recurrent Respiratory Papillomatosis: a Pre–post Analysis

  • 期刊论文

  • 发表日期：

    2026年4月15日

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  • Nguyen Thanh Tuan

摘要

Recurrent respiratory papillomatosis (RRP) is a chronic disease caused by human papillomavirus (HPV) types 6 and 11, often requiring repeated surgical interventions. Recent evidence suggests that adjuvant HPV vaccination may help reduce disease recurrence, but real-world data remain limited.This study aimed to evaluate the impact of quadrivalent HPV vaccine (Gardasil) as an adjuvant treatment on the recurrence burden in RRP patients under routine clinical care.We conducted a retrospective, single-center, within-subject pre–post study including 12 patients with histologically confirmed RRP who received adjuvant Gardasil vaccination. Each patient served as his or her own control. Recurrence outcomes during the 12 months before the first vaccine dose were compared with those during the 12 months after vaccination. The primary outcome was recurrence burden, defined as the number of clinically significant recurrences requiring surgical intervention. Secondary outcomes included recurrence rate per person-year, time to first post-vaccination recurrence, recurrence-free proportion at 12 months, and endoscopic status at follow-up. The total number of recurrences decreased from 25 in the pre-vaccination period to 10 in the post-vaccination period, corresponding to a 60.0% relative reduction. Mean recurrences per patient declined from 2.08 ± 1.00 to 0.83 ± 0.83, and the post-/pre-vaccination recurrence rate ratio was 0.40 (95% CI, 0.19–0.83; p = 0.0005). Five of 12 patients (41.7%) remained recurrence-free at 12 months after vaccination. Among patients who recurred, the median time to first post-vaccination recurrence was 4.5 months, while the estimated median recurrence-free survival for the whole cohort was 6.0 months. At the end of follow-up, 8 of 12 patients (66.7%) had no visible papillomas on endoscopic examination. No vaccine-related adverse events were observed. Adjuvant HPV vaccination was associated with a reduction in recurrence and increased recurrence-free survival in RRP patients in real-world settings. These findings support the potential therapeutic role of HPV vaccination as an adjunct to surgical treatment. Further large-scale studies are warranted to confirm these results.