Abstract / Summary
Background: Cervical cancer is the most common and prevalent health problem, and the leading cause of cervical cancer worldwide is human papillomavirus (HPV). There may be missed opportunities in conventional approaches due to genotype-specific risk and multiple infections. This study aimed to describe the distribution of each genotype and co-infection at anogenital sites in symptomatic Iraqi women.
Methods: In this prospective cross-sectional study, 100 women with clinically suspected HPV infection were consecutively enrolled between December 2025 and July 2026. A single specimen was collected from one of seven cervical, vulval, anal, or perianal sites. DNA was extracted using an automated magnetic-bead system, followed by post-PCR microarray hybridization for simultaneous detection of 35 HPV genotypes. Associations were assessed using exact and nonparametric tests.
Results: HPV DNA was detected in 65.0% of participants (95% CI, 55.3–73.6%), comprising LR-only (48%), HR/PHR-only (9%), and mixed LR/HR-PHR infections (8%). HPV-6 and HPV-11 predominated, accounting for 40.9% and 30.7% of genotype detections, respectively. Multiple-genotype infections occurred in 20%. Age and sampling site were not significantly associated with HPV risk category. Among HR/PHR detections, 63.2% comprised non-avalent vaccine-covered genotypes.
Conclusion: LR genotypes predominated, consistent with a wart-associated profile, while HR/PHR and mixed infections indicate clinically relevant oncogenic risk. Genotype-resolved microarray profiling may strengthen molecular surveillance and risk-informed HPV screening and vaccination strategies in Iraq.