Exploring HPV Genotype Dynamics in South Africa

A genotype survey from Eastern Cape Province, South Africa found >90% HPV positivity in HSIL and >92% in cervical cancer, with a substantial burden of non-vaccine types in high-grade lesions.

The cross-sectional genotype survey sampled 540 women across cervical cytology grades and included participants of differing HIV status recruited from a community health facility and a referral hospital. Although vaccine-targeted types remain common, non-vaccine types were frequently detected and concentrated in high-grade lesions, altering risk stratification and the predictive value of vaccine-targeted screening algorithms.

HIV status correlated with shifts in HPV genotype distribution and with greater lesion severity. Women living with HIV had higher prevalence and diversity of HPV genotypes, with non-vaccine types enriched in HSIL and cancer.