Distribution of high-risk human papillomavirus (HR-HPV) genotypes among women with normal cytology and cervical cancer: a hospital-based cross-sectional study in Mysore, India

Abstract

Cervical cancer remains a major public health burden in India, with persistent infection by high-risk human papillomavirus (HPV) recognized as the primary etiological factor. Understanding the distribution of high-risk HPV (HR-HPV) genotypes is essential for optimizing screening and vaccination strategies. Therefore, this study aimed to determine the prevalence and genotype distribution of HR-HPV among women aged 20–75 years attending tertiary care hospitals in Mysore, Karnataka, India. In this hospital-based cross-sectional study, cervicovaginal lavage (CVL) samples were collected from 172 non-pregnant women aged 20–75 years attending the Obstetrics and Gynecology Departments of JSS Hospital and Cheluvamba Hospital, or the Oncology Department of Krishnarajendra Hospital, Mysore, between August 2021 and March 2023. Cheluvamba hospital and Krishnarajendra hospital belongs to Mysore Medical College and Research Institute (MMCRI), Govt of Karnataka, Karnataka, India. Cytological evaluation was performed using the Papanicolaou (Pap) test. HPV DNA was detected by MY09/MY11 polymerase chain reaction (PCR), and HPV-positive participants were genotyped using the TRUPCR ® HR-HPV Genotyping Kit, which detects 14 high-risk HPV genotypes. Of the 172 participants, 117 (68.0%) had normal cytology, while 55 (32.0%) presented with cytological abnormalities or histologically confirmed cervical cancer. Squamous cell carcinoma (SCC) was the most common abnormality, accounting for 70.9% of abnormal cases. HPV DNA was detected in 47.0% of women with normal cytology and 80.0% of women with abnormal cytology ( p < 0.05). Genotyping analysis revealed HPV16 as the predominant high-risk genotype in both women with normal cytology and those with cervical cancer. Multiple HPV genotype infections were common, occurring in 49.1% of HPV-positive participants with normal cytology and 59.5% of cervical cancer cases. In addition to HPV16, HPV18, HPV31, HPV58, and HPV59 were among the most frequently detected high-risk genotypes. This hospital-based cross-sectional study provides insights into the distribution of high-risk HPV genotypes among women with normal cytology and cervical cancer in Mysore, India. HPV16 was the predominant genotype in both groups, with multiple HPV infections observed in majority of study participants. These findings contribute to the understanding of regional HPV genotype distribution and recommend the optimization of HPV-based screening strategies and vaccination programs for better outcomes.