High risk HPV genotypes: six year trends and distribution in South Western Uganda

Abstract

Persistent infection with High-Risk Human Papillomavirus (hrHPV) causes almost all cervical cancer cases, and the world is steadily moving towards primary HPV testing for cervical cancer screening. We determined the prevalence, distribution, and trends of hrHPV genotypes at Mbarara Regional Referral Hospital (MRRH), south western Uganda. In this retrospective study, we reviewed laboratory records at MRRH for a period of six years from January 2020 and July 2025. Data on age, district of residence, HIV status, HPV test result, HPV genotype and date of testing were collected and analyzed using STATA 17. Out of the 4,852 HPV test results we retrieved, the overall prevalence of hrHPV infection was 28.52% (1379/4,852) with a gradual increase from the year 2020 to 2025. The prevalence of hrHPV was highest among women aged < 19 years (66.71%, 12/18), and it showed a steady decrease with increasing age of participants. More than half (65.12%, 898/1379) of all positive hrHPV tests were non-16/18/45 high-risk HPV genotypes categorized as “other hrHPV”, which also showed a persistent increase in prevalence from 61.04% in 2020 to 63.53% in 2025. “Other hrHPV” genotypes also showed a gradual decline in prevalence with increasing age. Within the HIV positive population, the prevalence of “other hrHPV” genotype group result was consistently high from 64.79% (46/71) in 2020 to 66.55% (189/284) in 2023 to 63.53% (54/85) in 2025. Also, mixed HPV genotype infections showed a steady increase from 11.27% (8/71) in 2020 to 21.18% (18/85) in 2025. There is an elevated prevalence of hrHPV, especially those HPV genotypes categorized as “Other hrHPV,” and this prevalence is inversely proportional to age. As such, there is a need for implementation of extended hrHPV genotyping and more prospective studies to further describe individual hrHPV genotype prevalence, distribution, and trends.