Epidemiology and genotype distribution of human papillomavirus (HPV) in Northern Iran

Human papillomavirus (HPV) infection is the commonest sexually transmitted infection. High-risk HPV DNA is found in the vast majority of HPV-associated cervical cancers. This study aimed to determine the distribution of HPV genotypes in Golestan Province, Iran, a region with limited prior data. A cross-sectional study was conducted from October 2022 to October 2023. Genital or cervical samples from women (n = 996) and penile or anal samples from men (n = 8) were collected. HPV DNA detection and initial risk stratification (high-risk vs. low-risk) was performed with the Hybrid Capture II system (HC2; Digene). Specific genotype identification was inferred from the probe pools used. Out of 1,004 participants, at least one HPV genotype was identified in 391 (38.94%; 95% CI: 35.96%-41.99%). Of the HPV-positive samples, 155 (39.64%) had low-risk genotypes, 104 (26.59%) had high-risk genotypes, and 132 (33.77%) had mixed infections. The most common genotypes were HPV-6 (7.37%), HPV-11 (5.18%), HPV-16 (4.48%), HPV-62 (4.48%), and HPV-81 (3.98%). The mean age of HPV-positive participants was significantly lower than HPV-negative participants (34.26 ± 9.52 vs. 35.69 ± 9.54 years, p = 0.02), with the highest frequency in the 25–34 age group (42.5%). Of the 8 men, only one had a detectable HPV genotype (HPV-11); this finding is descriptive due to the small sample size. HPV infection is common in our population, particularly among women aged 25–34 years. The high prevalence of HPV-16, a primary cause of cervical cancer, underscores the importance of vaccination. These findings provide a valuable baseline reference to guide cervical cancer screening and HPV vaccination programs in Northern Iran.