Global prevalence of human papillomavirus in patients with recurrent respiratory papillomatosis: A systematic review and meta-analysis

Recurrent respiratory papillomatosis (RRP) is a rare, chronic disease strongly associated with human papillomavirus (HPV), particularly HPV6 and HPV11. However, the prevalence of HPV in patients with RRP remains incompletely characterized. We conducted a systematic review and meta-analysis of observational studies reporting HPV detection in patients with RRP globally. PubMed, Web of Science, Scopus, and ScienceDirect were searched from inception without language restrictions. Study quality was assessed using the Joanna Briggs Institute prevalence checklist, and pooled prevalence estimates were calculated using random-effects models. Sixty-six studies were included. The pooled prevalence of HPV was 91.6% (95% CI, 88.2-94.2; I²=76.2%). HPV6 and HPV11 prevalence was 61.1% and 41.2%, respectively. HPV prevalence was 94.7% in juvenile-onset and 86.5% in adult-onset RRP. Regional and methodological differences contributed to substantial heterogeneity. These findings confirm the pervasive association of HPV with RRP and provide an epidemiological benchmark for future surveillance and vaccination-impact assessment.