Frontiers in Cellular and Infection Microbiology · Oct 29, 2026
Age-specific HPV genotype distribution and associations with cervical lesions and vaginal microecological status in Northeast China: a retrospective study of 73,828 individuals
By He Y, Pan Y, Sheng Z et al.
Background: Persistent high-risk human papillomavirus (HR-HPV) infection is a major etiological factor in cervical carcinogenesis. HPV prevalence and genotype distribution show substantial geographic heterogeneity across China, highlighting the need for region-specific epidemiological data. This study characterized age-specific HPV infection and genotype patterns in Northeast China and further examined their associations with cervical pathology and vaginal microecological status. Methods: We retrospectively analyzed HPV genotyping data from 73,828 individuals tested between 2020 and 2024. Histopathological data were available for 8,755 women, and vaginal microecological assessments were available for 2,428 women. Age-related differences, HPV genotype distributions, infection patterns, and their associations with cervical pathology and vaginal microecological categories were evaluated using nonparametric and χ² tests. Results: Overall HPV positivity was 20.83% (15,376/73,828) and showed a bimodal age distribution, with the highest prevalence among participants aged < 25 years (34.44%) and a second peak at 60–65 years (25.90%). HPV16, HPV52, and HPV58 were the three most frequently detected genotypes. Single HR-HPV infection differed significantly across cervical histopathological categories and was most frequent in cervical cancer (57.81%, P < 0.001). HPV positivity also differed across vaginal microecological categories ( P < 0.001), with the highest rate observed in the bacterial vaginosis group (32.66%); however, no individual HPV genotype remained significantly associated with microecological category after FDR correction. Conclusion: These findings provide regional epidemiological evidence for HPV surveillance and cervical cancer prevention planning and support further prospective investigation of the relationship between vaginal microecological alterations and HPV infection.