Genotype-specific Human Papillomavirus patterns and their implications across the cervical cancer spectrum: A...

Human papillomavirus (HPV) testing is the preferred method for cervical cancer screening. We aimed to assess the distribution of HPV genotypes among women with screen-positive (SP) results and histopathological (HP) confirmed high-risk lesions.

Women aged 25-65 years presenting to the outpatient department who underwent routine cervical cancer screening and who screened positive were enrolled in the study. Patients referred with an SP report were also enrolled. HPV testing, colposcopic evaluation, and guided biopsy were performed. Follow-up cases of genital malignancies and hysterectomized women were excluded.

Out of 5687 women screened, 123 (2.2%) tested positive via cytology or visual methods, and 118 were analyzed. Most (84.7%) tested positive through liquid-based cytology (atypical squamous cells of undetermined significance and above, ASCUS+). HPV was detected in 56.8% of cases (67/118); 25% had multiple strains. HPV 16 was most prevalent (38.1%). Among women with biopsy-proven HSIL and above (bHSIL and bHSIL+) lesions, HPV 16 was most common (78%), followed by HPV 18 (14%) and 33 (12%). There was a strong correlation between HPV genotype positivity and presence of bHSIL and bHSIL+ lesions (ϕ = 0.7; P < 0.001). HPV 16, 18, 31, 33, and 45 were found in high-grade and invasive lesions. Testing for either all high-risk HPV types or a subset (16, 18, 31, 33, 45) had similar diagnostic accuracy.

This study highlights the predominance of HPV 16, 18, 31, 33, and 45 in cervical lesions, emphasizing the need for targeted screening and vaccination against these high-risk genotypes to reduce HPV-related disease burden in the Indian population.