Dynamic changes of HPV genotypes in a tourism-influenced populated area, Northeastern Iran

Human papillomavirus (HPV) comprises more than 230 genotypes; its oncogenic potential is a major concern, particularly in tourism-influenced regions. The present study was conducted to assess HPV prevalence and temporal changes in genotype distribution after an eight-year interval in subjects who were suspected of sexually transmitted infections (STIs). Professional physicians referred samples from 2,673 subjects to the main molecular diagnostic labs in North, Razavi, and South Khorasan provinces, as well as from a diverse group of tourists. The findings showed that HPV was detected in 1,185 (55.86%) females and 400 (72.46%) males (p = 0.01). HPV infection was most frequent in the 21-30 and 31-40 year-old groups, at 35.6% and 39.7%, respectively. Most cases clustered around five to six genotypes. The six most frequent genotypes included HPV-6 (56.62%; 77/136), HPV-16 (40.44%; 55/136), HPV-54 (36.03%; 49/136), HPV-43 (29.41%; 40/136), HPV-51 (29.41%; 40/136), and HPV-52 (28.68%; 39/136). Importantly, three prevalent genotypes (16, 51 and 52) are classified as HR-HPV. Compared with eight years ago, the percentage of HPV prevalence strongly increased by more than 28%, primarily in genital discharge samples. The most notable change (0.4% vs 5.1%) occurred in the proportion of individuals with more than four genotypes, i.e., currently 11.7 times higher than eight years ago. The greatest shift in genotype prevalence has occurred between HPV-16 and HPV-51 over the past few years. Moreover, compared to the previous study, minimal changes (0.90%) in prevalence and genotypes have been observed in South Khorasan, the highest in North and Razavi Khorasan provinces (14.5%) and also in tourist groups (3.2%). Therefore, the impact of transient populations and more likely changes in socioeconomic and cultural status in these areas, along with the progressive trends in HPV infection, should prompt health authorities to focus more on establishing HPV diagnostic facilities, screening, vaccination, and increasing public knowledge.