# Lineage and Sublineage Analysis of Human Papillomavirus Types 66 and 68 in Iran During 2021–2023: A Cross‐Sectional Study

## TL;DR

This study identifies the dominant lineages and sublineages of HPV types 66 and 68 in Iran, providing insights into their genetic diversity and potential implications for disease risk.

## Contribution

The study reports the first lineage and sublineage distribution of HPV 66 and 68 in Iran using E6 gene sequencing.

## Key findings

- HPV 66 predominantly belongs to lineage B, with sublineage B2 being the most common.
- HPV 68 is mainly lineage C, with sublineage C1 being the most prevalent.
- No significant differences in lineage distribution were found based on histology/cytology status.

## Abstract

Knowing the distribution of HPV lineages and sublineages can provide more information on this virus's epidemiology, evolution, and pathogenicity. The present study intends to investigate the sequence variations of the E6 gene to know the distribution of lineages and sublineages of HPV 66 and 68 types in Iran.

Seventy‐one HPV 66 and 59 HPV 68‐positive samples were investigated to identify their lineage/sublineages by hemi‐nested PCR and sequencing.

Most of the HPV 66‐infected samples belonged to lineage B (77.5%) and the remaining (22.5%) were classified as lineage A. For sublineage classification, 22.5%, 12.7%, and 64.8% were sublineages A1, B1, and B2, respectively. Most of the HPV 68‐positive samples were classified as lineage C (66.1%), followed by lineage A (25.4%), lineage D/E (6.8%), and lineage F (1.7%). According to detected sublineages, C1 was dominant (62.7%), followed by A1 (22%), D/E (6.8%), A2 (3.4%), C2 (3.4%), and F2 (1.7%). No statistically significant differences were observed concerning HPV 66 or 68 distinct lineages by histology/cytology status.

Our results showed that the B2 sublineage of HPV 66 and the C1 sublineage of HPV 68 were dominant in Iranian women. However, to elucidate the role of HPV 66 and 68 lineages in the pathogenicity risk of these two types, more studies with larger sample sizes are required.