HPV infection trends in Inner Mongolia across the pre- and pandemic periods of COVID-19: A single-center analysis

This study compares overall and risk-category (high-risk vs low-risk) human papillomavirus (HPV) infection rates among women undergoing health examinations in Hohhot, Inner Mongolia, before and during the COVID-19 pandemic. We analyzed 3714 women tested for HPV from January 2020 to December 2024. The participants were divided into 2 groups based on the local epidemiological timeline in Inner Mongolia: a pre-pandemic group (January 2020-December 2022, when COVID-19 cases were sporadic under strict containment measures), and a pandemic group (January 2023-December 2024, after restrictions were lifted and community transmission became widespread). The primary outcomes were overall HPV positivity and high-risk versus low-risk HPV positivity. Group differences were assessed using chi-square tests (α = 0.05). The overall HPV infection rate was 17.56% (652/3714). The positivity rate was 18.02% in the pre-pandemic period versus 16.89% in the pandemic period. Across years, the overall positivity and the high-risk positivity peaked in 2021, with significant heterogeneity across years (overall χ²=28.512, P <.001; high-risk χ²=25.940, P <.001). High-risk HPV positivity exceeded low-risk positivity in all years. In this single-center cohort, the overall HPV positivity showed a slight decline during the pandemic period compared with the pre-pandemic period, while high-risk types remained more common than low-risk types. These findings underscore the need to maintain HPV screening and vaccination efforts during public health emergencies.