Health & Biomedical Sciences Faculty Publications

Distribution of high-risk human papillomavirus genotypes and associated risk factors among women with normal and abnormal cervical cytology in Lagos, Nigeria

Document Type

Article

Publication Date

10-14-2026

Abstract

Background: Cervical cancer is the fourth most common cancer in women worldwide and is primarily driven by persistent infection with high-risk human papillomavirus (HR-HPV) genotypes. This study aimed to determine HR-HPV genotype distribution and associated risk factors in women with normal and abnormal cervical cytology in Lagos, Nigeria.

Methods: A total of 165 sexually active women were recruited from a tertiary gynecology referral clinic between July 2017 and June 2018. Cervical cytology was assessed using Pap smears, whereas HR-HPV was detected and genotyped using nested and multiplex polymerase chain reaction (PCR) targeting 18 HR-HPV genotypes (13 established and 5 probable high-risk types). Sociodemographic and clinical data were collected via questionnaires and analyzed using SPSS version 21. Associations between HR-HPV prevalence and risk factors were evaluated using chi-square and logistic regression analyses. Factors independently associated with HR-HPV infection were subsequently identified using multivariable logistic regression with Firth’s penalized-likelihood method.

Results: Among the 165 participants, 93 (56.4%) were positive for at least one of the 13 established high-risk HPV genotypes, while 116 (70.3%) were positive for at least one of the 18 tested established or probable high-risk HPV genotypes, with HPV-35 emerging as the predominant genotype (43.6%), followed by HPV-82 (20.0%), and HPV-73 (9.1%). Among women with abnormal cytology (21.8%), HPV-35 was the most frequent genotype across all cytological grades. Dual and multiple HR-HPV infections were common, occurring in 34.5% of all participants. History of sexually transmitted infection was significantly associated with HR-HPV infection (OR, 2.97; 95% CI 1.43–6.17; P = 0.003); later sexual debut (≥ 21 years) and a higher number of lifetime sexual partners showed elevated but not statistically significant odds ratios. After multivariable adjustment, condom use (adjusted odds ratio [AOR], 0.19; 95% CI 0.08–0.45; P <  0.001) and history of sexually transmitted infection (AOR, 3.27; 95% CI 1.47–7.25; P = 0.004) remained independently associated with HR-HPV infection, whereas age, educational status, and marital status did not.

Conclusions: This study revealed a high burden of HR-HPV among women in Lagos, with a predominance of genotypes not covered by current HPV vaccines. These findings underscore the urgent need for region-specific vaccine strategies, the integration of molecular diagnostics into routine screening, and targeted public health interventions to reduce HPV disease.

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This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. 

Publication Title

BMC Infectious Diseases

DOI

10.1186/s12879-026-14580-0

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