Molecular Investigation of Human Papillomavirus Infection in Women With Genital Lesions: A Cross-Sectional Study in Semnan, Iran Publisher



Gholizadeh O ; Kalantarneyestanaki MH ; Yasamineh S ; Tarahomi M ; Naderian R ; Eslami M ; Ghaffari H ; Rahmanian M
Source: Indian Journal of Gynecologic Oncology Published:2026

Abstract

Introduction: Human Papillomavirus (HPV) is a highly prevalent sexually transmitted infection, with low-risk (LR) types causing genital warts and high-risk (HR) types linked to cervical cancer, the second most common cancer in women globally. The rising incidence of HPV, with an estimated 493,000 new infections annually, underscores its significant impact on public health, particularly among young individuals. Early detection through molecular methods is critical due to the often asymptomatic nature of HPV infections. Studies also suggest a link between HPV and other cancers, such as prostate cancer, with prevalence varying by age. This study, conducted in Semnan City, Iran, aims to molecularly investigate HPV infection among women with genital lesions, address the lack of local data and enhance medical awareness. Material and method: This cross-sectional study was conducted from March 2022 to March 2023 in Semnan City, Iran, and included 237 women with genital lesions confirmed by gynecologists and pathologists. Demographic data, risk factors, Pap smear results, and clinical information were collected for analysis. Nucleic acid extraction was performed using a viral DNA kit to ensure sample purity, following the manufacturer’s instructions. HPV detection was performed using Real-Time PCR and the TaqMan Probe method, incorporating negative and positive controls to ensure accuracy. Samples were selected from women who met the study’s inclusion criteria, ensuring that the collected data was relevant and of high quality. Statistical analysis was performed using SPSS version 23, Stata version 21, and GraphPad Prism software. Analytical methods, including Spearman’s rank correlation, Mann-Whitney test, and Kruskal-Wallis test, were employed to assess associations and test hypotheses at a significance level of α = 0.05. Results: Among the 237 samples, HPV was detected in 54 cases (22.7%). The most common Pap smear result was “normal with inflammation” (42.6%), followed by “normal with reactive cellular change” (31.5%). The prevalence of Low-Grade Squamous Intraepithelial Lesion (LSIL), Atypical Squamous Cells, cannot exclude High-Grade Squamous Intraepithelial Lesion (ASC-H), and Atypical Squamous Cells of Undetermined Significance (ASCUS) was 1.9%, 3.7%, and 20.4%, respectively. HPV-16 was the most prevalent type (29.6%), followed by HPV-18 (11.1%) and other HR types (38.9%). Co-infection with HPV-16 and HPV-45 was observed in 1.9% of cases. Demographically, the majority of patients were married (85.2%), with most having HPV-affected spouses (51.9%) or other sexually transmitted diseases (STDs) (79.6%). No significant correlations were found between demographic variables and HPV types. The average age of patients with HPV-16, HPV-18, and other HR types was 31.88 ± 7.10, 32.33 ± 7.00, and 25.00 ± 5.65 years, respectively. Conclusion: This study highlights a significant prevalence of HPV, particularly HPV-16, among women with genital lesions in Semnan City. Specific HPV types were associated with abnormal Pap smear results, emphasizing the need for targeted screening programs. Demographic factors, such as marital status and partner’s infection status, play a role in HPV transmission dynamics. While these findings provide valuable insights, further studies are essential to comprehensively understand HPV epidemiology and develop effective public health strategies to combat the diverse spectrum of HPV types. © The Author(s) under exclusive licence to Association of Gynecologic Oncologists of India 2025.