Prevalence and genotype distribution of HPV infection among women in 2021-2023 in southern Iran: The rising trend of HPV infection among women.

Abstract

Background: Human papillomavirus (HPV) infection is the leading cause of genital disease. More information on the prevalence and distribution of genital HPV subtypes in the female population is needed to inform preventive strategies. Geographical, social, economic, and ethnic barriers in developing countries challenge the development of preventive measures for cervical cancer. For the first time, we sought to determine the prevalence of HPV infection among women referred to gynecologists in southern Iran.

Methods: This cross-sectional study was conducted in Hormozgan, Iran from July 2021 to July 2023 on various cervical specimens from all outpatients referred to the Virology Laboratory of the Infectious and Tropical Diseases Research Center. HPV DNA was extracted from genital swabs of the study participants using the QIAamp DNA Extraction Kit. Genotyping was performed on 3960 cases using multiplex PCR and a microarray chip (Master Diagnóstica, Granada, Spain) to identify 18 high-risk (HR) and 18 low-risk (LR) HPV genotypes. Demographic data were statistically analyzed in relation to viral data.

Results: Of 3960 cases, 1303 (32.90%) were HPV positive. HPV positive patients were younger than negative patients. The positive rate was higher in the age group 20 to 40 years (72%). Single HPV infection was the most common pattern, accounting for 52.57% of cases while double infection accounted for 21.18% of the positive cases. The most common HR-HPV subtypes in southern Iran were HPV 16, 52, 31, and 53 (12.58, 8.36, 6.60, and 6.44%, respectively). Also, the most common LR-HPV subtypes were HPV6, 42, 62.81, and 44.55 (14.58, 12.58, 8.36, and 8.05, respectively). A comparison of the prevalence of HPV infection showed an increase in cases (in 2022-2023 (36.05%) compared with that in 2021-2022 (29.92%)), a decrease in the age of infected women (41.50% for 2022-2023 and 42.05% for 2021-2022) and an increase in multi-genotypic cases (42.44% for 2022-2023 and 31.24% for 2021-2022).

Conclusions: These observations highlight the need for a program to educate the young population of the community as well as the implementation of infection control measures against HPV infection, especially in the case of mass HPV vaccination of the general population.