The prevalence of human papillomavirus infection among women in primary health care, Santiago, Chile (2015-2024)

Cervical cancer (CC) remains a major public health concern and is the second leading cause of cancer-related mortality among Chilean women aged 25-64 years. Persistent infection with high-risk human papillomavirus (HR-HPV) is a necessary and etiological factor for CC development. This study aimed to estimate the prevalence and genotype distribution of HPV among women attending primary health care centers in Santiago, Chile, between 2015 and 2024.

Cervical samples (n = 6431) were collected from women aged 25-64 years. Cellular DNA was extracted using automated procedures and amplified by real-time polymerase chain reaction (PCR). HPV-positive samples were genotyped using PCR-reverse line blot hybridization and Sanger sequencing. Prevalence estimates were stratified by age group and calendar year.

The overall prevalence of HR-HPV infection was 15.89%. HR-HPV prevalence increased steadily over the study period, from 9.98% in 2015-23.42% in 2024. The highest prevalence was observed among women aged 25-34 years (22.80%), with a progressive decline across older age groups. The most frequently detected HR-HPV genotypes were HPV-16 (4.28%), HPV-59 (2.11%), HPV-31 (1.93%), HPV-58 (1.76%), and HPV-52 (1.51%). Overall, 57.81% of HR-HPV infections were attributable to genotypes included in the nonavalent vaccine, whereas 42.19% corresponded to non-vaccine genotypes. Among non-vaccine HR-HPV types, HPV-59 (9.93%), HPV-56 (6.06%), and HPV-39 (5.77%) were the most prevalent.

HR-HPV prevalence in this population was higher than previously reported in comparable settings, with a 2.35-fold increase observed between 2015 and 2024. These findings highlight the need for continuous HPV surveillance and may inform cervical cancer screening and vaccination strategies in Chile.