Prevalence and Genotype Distribution of High-Risk Human Papillomavirus Infection among Women in Beijing, China: A Two-Year Cross-Sectional Comparative Study

Research Article

Austin J Cancer Clin Res. 2022; 9(1): 1102.

Prevalence and Genotype Distribution of High-Risk Human Papillomavirus Infection among Women in Beijing, China: A Two-Year Cross-Sectional Comparative Study

Qiu XM1#, Liu RZ1#, Wang SZ2 and Zhang XF2*

¹Beijing Chaoyang Hospital, Capital Medical University, Beijing, China

²Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China

#These authors have contributed equally to this article

*Corresponding author: Zhang XF, Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China

Received: May 09, 2022; Accepted: June 27, 2022; Published: July 04, 2022


Objective: Our study aimed to observe the dynamic epidemiological characteristics of high-risk human papillomavirus (HR-HPV) infection among women in Beijing, China, between 2015 and 2020.

Methods: A retrospective analysis was performed on all collected cervical specimens from women who underwent HR-HPV examination in the outpatient clinic, ward, and physical examination center of Beijing Chao yang Hospital, Capital Medical University, from April to December 2015, and from April to December 2020. Real-time polymerase chain reaction (PCR) was applied to detect 15 HR-HPV genotypes.

Results: A total of 26003 patients were enrolled in the study. No statistical difference was detected in the HR-HPV infection rate between the two years (22.1% versus 23.1%, P>0.05). The top five genotypes were HPV52/58, 16, 56 and 51, in descending order in both years. Single HR-HPV infection was the most frequent infection type in both years. The proportion of single infection in 2015 and 2020 were 73.32% (2218/3025) and 76.22% (2167/2843), respectively. There was no significant difference in infection rates across age groups in 2015, but the infection rate curve of 2020 was “bimodal”, with two peaks in young women (≤24 years-old group) group and the 60-64 years-old (y) group, with the trough in the 45-49y group.

Conclusions: There was no significant change in the overall HR-HPV infection rate of women in Beijing, and the genotype distribution of HR-HPV seldom changed except for the age-related infection rate during the last 5 years. These findings may provide baseline information for local administrations topromote targeted HPV screening and HPV vaccination.

Keywords: Human Papillomavirus; Infection; Prevalence Rate; Genotype


AIS: Adenocarcinoma in Situ; CIN: Cervical Intraepithelial Neoplasia; CSCCP: Chinese Society for Colposcopy and Cervical Pathology of China Healthy Birth Science Association; GCO: Global Cancer Observatory; HPV: Human Papillomavirus; HR-HPV: High- Risk HPV; HSIL: High-Grade Squamous Intraepithelial Lesions; LRHPV: Low-Risk HPV; PCR: Polymerase Chain Reaction; Y: Yearsold.


According to the Global Cancer Observatory (GCO), the incidence of cervical cancer in women ranked fourth (8.4%) in 2020, and the mortality rate also ranked fourth (7.7%). Cervical cancer is also the global cancer model’s leading cause of death in 36 countries. Affected by the increase in socio-economic level, the improvement of reproductive health, related publicity and education work, and the continuous implementation of HPV vaccination work, the incidence of cervical cancer in developed countries showed a downward trend [1]. However, cervical cancer remains a burden in China. In the past 15 years, the incidence and mortality rate of cervical cancer have shown an increasing trend. The incidence rate has increased from 11.26/100,000 in 2003 to 13.73/100,000 in 2018, and the mortality rate has risen from 4.88/100,000 in 2003 to 5.89/100,000 in 2018 [2]. So cervical cancer continues to be one of the leading causes of death in Chinese women.

HPV is a diverse group of small DNA viruses consisting of double-stranded cyclic DNA with 8,000 base pairs. The persistence of viral infections and the uncontrolled expression of E6 and E7 viral oncogenes are critical to its transformation. Since the discovery in the 1990s that persistent HR-HPV infection is a necessary but inadequate condition for invasive cervical cancer [3], HPV testing has gradually become an essential form of secondary prevention of cervical cancer. 80% of women are infected with HPV throughout their lifetime, but 90% of these infections will go away automatically [4]. Among the more than 100 HPV subtypes discovered so far, they can be subdivided into HR-HPV, possible HR-HPV, and low-risk HPV (LR-HPV), according to the degree of malignancy of the disease. Of the 15 types of HR-HPV, HPV16, 18, 45, 31, 33, 52, 58, and 35 were responsible for 95 percent of HPV DNA-positive cervical squamous cell carcinomas [5].

Cervical cytology, HPV vaccination, and HPV infection screening are all effective methods of preventing cervical cancer and precancerous lesions [6], with HPV vaccination providing a 66 to 100 percent protective effect against cervical cancer [7]. However, HPV infection rates, HPV subtype distribution, and high-risk age groups can vary between different countries and regions around the world or within a country due to demographic, geographic, socioeconomic level, and ethnic differences [8]. At the same time, with the development of vaccine immunization and herd immunity effects, the distribution of significant subtypes of HPV will also change [9,10]. As a result, understanding the epidemiological characteristics and trends of HR-HPV infection is critical for HPV screening and vaccine development. Although there are many epidemiological studies of HR-HPV infection in different regions in China, the existing studies still have insufficient data and a lack of comparison over time. Therefore, this study conducted a retrospective crosssectional investigation in 2015 and 2020, respectively, and obtained the epidemiological characteristics and changing trends of HR-HPV infection in two years, which provided an essential basis for the prevention and treatment of cervical cancer and HPV vaccination in women in Beijing. To the best of our knowledge, this is the first study to compare a two-year cross-sectional HR-HPV infection status, which provides horizontal and longitudinal perspectives for further study.

Materials and Methods

Clinical Data Collection

A total of 26933 women aged 16-95y presented to the outpatient clinics, wards, and physical examination center of Beijing Chao yang Hospital from April to December in 2015 and from April to December in 2020 were tested for type-specific HR-HPV analyses. Inclusion criteria: previous sexual history; non-menstrual period; non-pregnancy; non-breastfeeding period. Exclusion criteria: no prior history of sexual life; women who were menstruating, pregnant, or lactating when sampling. Patients’ information was obtained from medical records. The Ethics Committee approved this study of Chao yang Hospital, affiliated with Capital Medical University.

Sampling Method

Patients did not use intravaginal medications, vaginal douching, or sterilization for 3 days before testing; they were a sexual within 24 hours. Sampling method: use an aseptic cotton swab to wipe the cervical orifice secretions clean; take a cervical sample from each woman with a cell brush; re-suspend the sample in 2.5mL of liquid cytology medium; and send it for testing for type-specific HR-HPV.

HPV DNA Genotyping

HPV DNA genotype testing was performed using a HPV genotyping Real-time PCR kit (Shanghai ZJ Bio-Tech Co., LTD.) according to standard instructions as described in previous studies [11]. Fifteen HPV genotypes were detected (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, 68, 82).

Statistical Analysis

Analyses were conducted using the commercially available statistical SPSS25.0 software. The positive rate and infection rate were used as descriptive indicators; the Chi-square test was used for statistical analysis. Statistical significance was accepted if the p value was less than 0.05.


Overall Prevalence Rate of HR-HPV Infection

In 2015, 13692 women were enrolled in the study, of which 3025 were HR-HPV positive, with an infection rate of 22.1%. In 2020, 12311 women were enrolled in this study, of which 2843 were HRHPV positive, with an infection rate of 23.1%. The results showed no statistical differences (P>0.05).

The Distribution of HR-HPV Genotypes

In 2015, the top five positive rates of HR-HPV infection genotypes were HPV58, 52, 16, 56 and 51, in descending order. However, in 2020, the top five HR-HPV genotypes from high to low were HPV52, 58, 16, 56 and 51. Overall, the most prevalent HPV genotypes in both years were HPV52/58, followed by HPV16. The positive rates of HPV18 and HPV 16 had a mild decline in 2020 compared with that in 2015, but there was no significant difference between the two years (Table 1). The prevalence rate of HPV58 and 68 in 2020 was lower than that in 2015 (P<0.05).In contrast, the prevalence rate of HPV66 and 82 was higher than that in 2015 (P<0.05) (Figure 1).