the Distribution of high-risk HPV genotypes and their association with cervical lesions in a screening program for vulnerable populations in Cali, Colombia.

Abstract

Background: Infection by high-risk human papillomavirus (HPV-HR) is the primary cause of cervical cancer. The distribution of genotypes and their association with cervical lesions varies depending on the population context. Aim: To describe the distribution of HPV-HR genotypes and evaluate their association with cervical lesions in women from a vulnerable population in southwestern Colombia.

Methods: A cross-sectional analytical study based on secondary data (2017-2021) in women aged 30-69 years who tested positive for HPV DNA (RT‑PCR). As a contextual hypothesis, considering the age group and socioeconomic barriers, it is assumed that previous vaccination coverage was low. The association between genotypes and lesions was assessed using the odds ratio (OR) with a 95% CI.

Results: 3,541 women with HPV-HR were analyzed. Genotype 16 showed a strong association with intraepithelial lesions (OR 5.97; 95% CI: 3.25-10.94), accounting for the largest proportion of premalignant and malignant lesions confirmed by cytology and colposcopy. Other genotypes showed non-significant associations or heterogeneous behavior. Coinfection did not increase the risk in the absence of HPV 16.

Conclusions: HPV 16 was the main genotype associated with more severe cervical lesions in this population. The reduced clinical impact of other genotypes underscores the need for differentiated follow-up strategies in screening programs.