By Pamela Tom | HPVANDME Founder
A new study finds chronic HPV infection in the upper respiratory tract may lead to cancer in the lungs—and there is no current treatment. The findings by Dr. Sara Pai and her colleagues stemmed from a clinical trial that sought to discover why some people have persistent HPV infection.
Clinical Trial
The nationwide study, conducted at Massachusetts General Hospital, Boston, MA and NorthShore University Health System, Evanston, IL., appeared online in The Lancet (July 18, 2022). After each participant received a baseline chest CT scan, researchers began finding lesions in the lungs of certain patients who were completely unaware of the abnormality.
Dr. Pai says with no standard treatment, the virus can continue to replicate and grow, forming lesions inside the lungs. The current remedy: the surgical removal of the virus-affected tissue or removing lung tissue bit by bit over time. This may involve multiple procedures, affecting the patient’s quality of life.
HPV 6 and 11
In 2015, HPV-related oropharyngeal cancer became the #1 HPV cancer, surpassing incidents of cervical cancer. Such cases of HPV throat are usually caused by HPV types 16 and 18. The study found lower risk types, HPV 6 and 11, can infect the upper respiratory tract and cause Recurrent Respiratory Papillomatosis, or RRP. The name reflects the fact that the infection keeps recurring. The condition impacts the voice and breathing. Dr. Pai says so far, she has not seen a HPV-16 throat cancer patient with HPV 6 or 11 RRP.
RRP can be developed as a juvenile or adult. The study cites the case of a 33 year-old woman who was diagnosed with RRP at one year-old. HPV can be contracted during birth as the baby passes through the vaginal canal. As a result, the woman underwent more than 100 surgical procedures for RRP involving her larynx and trachea. At age 31, the woman’s CT scan revealed a lesion in her lung.
“It is important to understand whether a patient may have HPV infection in their lungs,” says Dr. Pai. “Even though HPV 6 and 11 are considered low risk in terms of causing cancer. Once HPV infects the lungs, we find that individuals have an increased risk for developing lung cancer, and that risk jumps 32-fold.”
The HPV Vaccine Prevents Infection
The HPV vaccine protects against HPV 6 and 11. While it cannot protect people exposed to HPV at birth, the vaccine does provide protection to people who get vaccinated before they are exposed to the virus. That’s why the HPV vaccine is recommended for adolescents at age 11-12, or as early as age nine.
Who is At Risk? What are the Symptoms?
Who are the people at most risk? Those with chronic HPV infection in other parts of his or her body and weak immune systems are at most risk for RPP. The symptoms include a hoarse voice that doesn’t improve and difficulty breathing.
Dr. Pai hopes that the study will help inform the medical community about the dangers of HPV in the lungs and why in some people, the immune system cannot get rid of the virus.
“This is a disease process that is not fully appreciated in the medical field,” says Dr. Pai. “We need to better understand what factors are driving HPV to the lungs in order to develop standard algorithms so patients with RRP can be treated uniformly.”
The paper may be downloaded here until 9/7/22. Dr. Pai is an associate professor at Harvard Medical School and Massachusetts General Hospital. Her research focuses on how “HPV can invade the immune system and strategies that can be applied to reactivate the host immune response against the virus.”