Prevalence, genotype distribution and clearance time of human papillomavirus infection: A retrospective study

Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide and a major cause of cervical and other anogenital cancers. In Iraq, limited data exist on HPV prevalence, genotype distribution, and infection clearance, especially in large, representative samples. We aim to determine the prevalence, genotype distribution, and clearance time of HPV infection within a sample of adults that sought HPV testing in Duhok city, Kurdistan region of Iraq. A retrospective cross-sectional study was conducted including 802 adults aged 18 years and older (640 females, 162 males) who were tested for HPV in the clinic from January 2020 to May 2025. Samples were collected via cervical, penile, and urethral brushes. PCR-based assays identified 36 HPV genotypes. SPSS was used for statistical analyses including prevalence estimation, genotype distribution, and Kaplan-Meier analysis for clearance time. The overall HPV prevalence was 38.8%, significantly higher in males (53.7%) than females (35%) (P = .001). High-risk HPV genotypes were detected in 18.5% and low-risk in 31.5% of participants, with 53.7% co-infected with multiple genotypes. The most common low-risk genotypes were HPV6, 62, 81, and 11, while HPV56, 66, and 16 were the most frequent high-risk types. Among 46 infected individuals with repeat testing, half had cleared the infection, with mean clearance times of 163 days in men and 243 days in women. HPV infection is highly prevalent in the sample of adults who were tested for HPV in Duhok city, with notable genotype diversity and higher infection rates in males. These findings highlight the need for HPV vaccination integration into national immunization programs, expanded screening efforts, and culturally tailored public health strategies in Iraq. Further population-based research is essential to guide prevention policies.