HPV genotype distribution and cervical lesion severity in HPV-positive women: a study from the Guizhou Province cervical cancer screening program
To analyze the infection status and subtype distribution of high-risk human papillomavirus (hrHPV) and their relationship with cervical lesions among women undergoing cervical cancer screening in Guizhou Province, thereby informing HPV vaccine selection and optimizing cervical cancer screening strategies. Data were sourced from the 2024 Guizhou Province free cervical cancer screening program for women. The prevalence of hrHPV-positive samples was analyzed, and age-specific associations between HPV genotypes and severe lesions were explored. Furthermore, the co-infection propensity for any two HPV genotypes was assessed by calculating the infection rate ratio. The overall hrHPV infection rate in the Guizhou region of China was 10.09%. Among hrHPV-positive individuals, the detection rate of cervical lesions was 11.49%. In hrHPV-positive women with cervical lesions, the most common genotypes were HPV16, 52, and 58. HPV16 was predominant across the entire spectrum of cervical lesions, and its prevalence increased significantly with the severity of cervical lesions, from 21.7% in LSIL to 39.4% in HSIL, and to 56.7% in cervical cancer (p < 0.001). However, the primary HPV types leading to cervical cancer were HPV16, 18, and 33. The infection pattern was predominantly single genotype (71.8%), with multiple genotypes accounting for only 28.2%. Among multiple infections, dual infection was the most common. The most frequent mixed genotype combinations were HPV16 + 52, 52 + 58, and 16 + 58. Significant co-infection preferences were observed for HPV16 with 33, HPV16 with 58, and HPV18 with 59. Analysis of the association between HPV genotype risk grouping and age across different cervical lesion grades showed that in the LSIL group, women aged 55-65 had a significantly 24% higher risk of HPV16 infection compared to those aged 35-45 (P = 0.023), while the risk of 'Other hrHPV' infection was significantly reduced by 8% (P = 0.019). In the HSIL group, the 45-55 age group had a significantly 11% lower risk of 'Other hrHPV' infection compared to the 35-45 age group. HPV16 predominates across the entire cervical lesion spectrum, with its prevalence significantly increasing with lesion severity. Furthermore, the nonavalent HPV vaccine covers all prevalent oncogenic hrHPV genotypes in this region (except for HPV56). These findings provide crucial epidemiological evidence for optimizing HPV vaccination strategies and cervical cancer screening programs.