Prevalence and genotype distribution of HPV and cervical morphological results in southern Hunan Province, China: analyses of results from a tertiary institution, 2018-2020

Abstract

Background: Human papillomavirus (HPV) infection is closely correlated with cervical lesions. However, the HPV prevalence varies among different districts. This retrospective study investigated the HPV genotype distribution and its relationship with cervical lesions in southern Hunan Province.Methods: HPV and morphological examinations results from HPV-positive patients during 2018-2020 were reviewed. A total of 49,955 gynaecological inpatients and outpatients, each of whom underwent HPV testing, were included in this study. Available cytology and relevant histological examination results were reviewed. Furthermore, we limited the interval between HPV testing and the receipt of associated morphological results (if available) in the same patient to within 180 days to ensure their correlation when analysing their relationship.Results: The overall HPV positivity rate was 14.6%. The top five most prevalent HPV genotypes were HPV52, 16, 58, 53 and 51 (23.0%, 17.5%, 14.3%, 7.5%, and 6.0%, respectively). The HPV prevalence in the group aged ≤20 years was the highest, followed by the prevalence in the group aged 60–69 years. Single infection was the main type of HPV infection, and multiple infections occurred in 21.96% (1600/7286) of the infected women. Cytological and pathological abnormalities were mainly associated with infection with HPV16, 52 and 58. Further analysis found that HPV16, 58, 52 and 33 were the main genotypes associated with high-grade squamous lesions (HSIL) and that HPV16, 31, 33 and 58 were independent risk factors for HSIL (OR=1.70, 1.99, 2.59, 2.29; all P<0.05). HPV16, 58, 52, 18 and 33 were the most frequent genotypes detected in squamous cell carcinoma (SCC) patients, and HPV16 and 18 were independent risk factors for cervical carcinomas (OR=6.72, P<0.001; OR=1.67, P=0.001).Conclusion: This retrospective study demonstrated the prevalence and the distribution characteristics of HPV infection and its correlation with cervical lesions in southern Hunan Province. The comprehensive results of this survey can guide HPV vaccine research to protect against some common genotypes in China.