Epidemiological profile of HPV infection, associations with cervical lesions and vaginal microecological disorders, and nine-valent vaccine coverage in Northwest China: a 6-year retrospective study of 57,035 women

A six-year retrospective study of 57,035 female outpatients at a tertiary hospital in Shaanxi Province found that 28.77% were positive for human papillomavirus (HPV), with isolated high-risk HPV infections and single-genotype patterns dominating the results. The analysis, reported in Virology Journal, also examined persistent infections, associations between particular HPV genotypes and cervical lesions, relationships with vaginal microecological disorders, and the prevalence of genotypes covered by the nine-valent HPV vaccine.

The hospital-based study included female outpatients who underwent HPV genotyping from 2016 through 2021. HPV prevalence followed a bimodal age distribution, reaching its highest level among participants aged 26–30 years and showing a secondary peak among those aged 61 years or older. HPV16 was the most prevalent high-risk genotype, followed by HPV52, HPV58, HPV53 and HPV51. Because the study recruited patients at one tertiary hospital, the findings characterize the women included in the clinical sample rather than establishing population-representative HPV prevalence across Northwest China.

Persistent infection was assessed in 3,542 patients who returned for follow-up. Of these, 33.75% had persistent HPV infection, with the highest persistence rate recorded among people with mixed high-risk and low-risk HPV infections. HPV positivity was correlated with elevated abnormal rates on thin-prep cytology tests, and nine high-risk HPV genotypes were significantly associated with cytological abnormalities. In the cervical cancer cases included in the analysis, HPV16 accounted for 69.7%. These findings describe statistical associations in the retrospective cohort; they do not establish that a particular HPV genotype caused an individual cervical lesion or cancer.

The study also evaluated associations between HPV infection and bacterial vaginosis, aerobic vaginitis, trichomonal vaginitis, vulvovaginal candidiasis and mixed vaginitis. HPV positivity was positively associated with bacterial vaginosis, trichomoniasis and mixed vaginitis but inversely associated with vulvovaginal candidiasis. The strength and direction of these relationships varied by HPV subtype, indicating that the results differed among viral types. The supplied findings document associations within the analyzed patients and do not show that HPV caused a vaginal disorder or that any vaginal disorder increased HPV risk. Similarly, the reported increase in the proportion of nine-valent-vaccine-covered genotypes with increasing cervical lesion severity describes the distribution of viral genotypes in the cohort, not vaccination uptake or the vaccine’s protective effect.

Subject of Research: HPV epidemiology, cervical lesions and vaginal microecological disorders among female outpatients in Shaanxi Province

Article Title: Epidemiological profile of HPV infection, associations with cervical lesions and vaginal microecological disorders, and nine-valent vaccine coverage in Northwest China: a 6-year retrospective study of 57,035 women

Article References: Li, X., Li, R., Jia, X., Wei, L., Yang, Z., Zhang, T., Li, J., Zhang, Q., Feng, H., Tan, F., Chen, Y., Zeng, L., Pan, Y., Pei, M., & Li, N. (2026). Epidemiological profile of HPV infection, associations with cervical lesions and vaginal microecological disorders, and nine-valent vaccine coverage in Northwest China: a 6-year retrospective study of 57,035 women. Virology Journal. https://doi.org/10.1186/s12985-026-03341-9

Image Credits: AI Generated

DOI: 10.1186/s12985-026-03341-9

Keywords: human papillomavirus, HPV16, cervical lesions, persistent infection, cervical cancer, bacterial vaginosis, trichomoniasis, vulvovaginal candidiasis, nine-valent HPV vaccine, Shaanxi Province, Epidemiological, profile