Epidemiological analysis of human papillomavirus and its subtype infections in 36,248 women in Wuhan, China

TL;DR

This study analyzed HPV infections in over 36,000 women in Wuhan, China, finding a high prevalence and identifying key subtypes to guide vaccination and cervical cancer prevention.

Contribution

The study provides a detailed epidemiological profile of HPV subtypes in Wuhan, highlighting vaccine coverage gaps and regional differences in infection patterns.

Findings

HPV prevalence was 24.27%, with a U-shaped age distribution peaking in young and older women.

HPV-52 and 58 were the most common high-risk subtypes, and the nine-valent vaccine covered only 15.27% of genotypes.

New vaccine development is urgently needed to address high-risk subtypes not covered by current vaccines.

Abstract

We aimed to analyze the distribution and characteristics of human papillomavirus (HPV) and its subtype infections in women in Wuhan, China, with the objective of providing a reference for the prevention and control of HPV infection and cervical cancer.

We performed a retrospective study of women who visited a gynecology clinic in Wuhan and underwent HPV typing between January 2021 and December 2023. We determined the HPV subtypes by polymerase chain reaction and diversion hybridization and analyzed the epidemiologic characteristics of the women by age and year groups.

Among 36,248 women, 8,796 were positive for HPV infection, yielding a prevalence rate of 24.27% and showing an annual increasing trend. Single infection was the main type of HPV infection, accounting for 16.83% of cases, whereas multiple infections accounted for 7.44%. The prevalence rates of high-risk, low-risk, and mixed high- and low-risk HPV infections were 18.59, 2.66, and 3.01%, respectively. The prevalence rates of HPV infection in different age groups showed a bimodal U-shaped distribution, with the first and second peaks observed in the ≤24 year (21.45%) and the 55–64 year (32.45%) groups, respectively. A total of 21 HPV subtypes were identified. The five most common high-risk HPV subtypes were HPV-52, 58, 16, 53, and 51, with prevalence rates of 6.12, 3.66, 3.44, 2.68, and 2.41%, respectively. The three most common low-risk HPV subtypes were HPV-CP8304, 42, and 44, with prevalence rates of 2.17, 1.37, and 0.89%, respectively. In the ≤24 year group, the three most common subtypes were HPV-52, 16, and 58. In the ≥55 year group, the three most common subtypes were HPV-52, 58, and 16. The nine-valent vaccine had a 15.27% HPV genotype coverage rate. The high-risk genotype rate not covered by the vaccine was 10.44%.

The HPV prevalence rate among women in Wuhan was higher than that in certain developed cities in China. Among the three existing vaccines, the nine-valent vaccine is more suitable for women in Wuhan. It is necessary to further promote the cervical cancer vaccination program among young women. In addition, cervical cancer screening should be strongly advocated in perimenopausal women. The high frequency of high-risk HPV subtypes that are not covered by existing vaccines highlights the urgent need for new vaccine development based on the HPV epidemiology in the local population.

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