# High-Risk Human Papillomavirus (HPV) Status in Colposcopically Diagnosed Low- and High-Grade Cervical Lesions: A Cross-Sectional Study From a Tertiary Care Center in South India

## TL;DR

This study shows that high-risk HPV DNA testing is effective in identifying severe cervical lesions, especially when combined with colposcopy.

## Contribution

The study provides new data on HPV prevalence in cervical lesions in a South Indian population using a cross-sectional design.

## Key findings

- HPV DNA was detected in 70% of participants, with all high-grade lesions testing positive.
- HPV positivity was significantly associated with lesion severity (p = 0.03).
- HPV testing showed higher detection rates in high-grade lesions compared to low-grade ones.

## Abstract

Background

Persistent infection with high-risk human papillomavirus (HPV) is the central etiological factor in the development of cervical intraepithelial neoplasia and cervical cancer. While cytology-based screening has been the traditional approach, HPV DNA testing is emerging as a more sensitive modality, especially in resource-constrained settings. This study aimed to determine the prevalence of HPV DNA positivity in women with low-grade (LSIL) and high-grade (HSIL) cervical lesions as identified by colposcopy.

Methods

This was a cross-sectional observational study conducted over 18 months (January 2023 to June 2025) in the Department of Obstetrics and Gynaecology at a tertiary care hospital (Sree Balaji Medical College and Hospital) in South India. Women aged 25-55 years with abnormal cervical findings underwent colposcopic evaluation. Lesions were categorized as LSIL or HSIL based on colposcopic impressions. Cervical samples were subjected to high-risk HPV DNA testing using polymerase chain reaction (PCR). The primary outcome was HPV positivity across lesion grades.

Results

Among 60 participants, 12 (20.0%) were primigravida, 11 (18.3%) were second gravida, and 37 (61.7%) were gravida three or above. Nulliparity was observed in 12 (20.0%) women, while 35 (58.3%) had ≥2 deliveries. Irregular menstrual cycles were reported by 23 (38.3%), postcoital bleeding by 16 (26.7%), and abnormal vaginal discharge by 18 (30.0%). Colposcopy revealed LSIL in 46 (76.7%) and HSIL in 14 (23.3%). HPV DNA was detected in 42 (70.0%) participants, with all HSIL cases [14 (100.0%)] and 28 (60.9%) of LSIL cases testing positive, indicating a significant association between HPV positivity and lesion severity (p = 0.03).

Conclusion

HPV DNA testing demonstrated high detection rates, particularly among women with HSIL, reinforcing its utility as a triage tool in cervical cancer prevention. Integration of HPV testing with colposcopy can enhance early identification and risk stratification of cervical lesions, especially in settings where cytology-based screening is inconsistent.