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Peer-reviewedCC BY 4.0PLOS One

Dynamic changes of HPV genotypes in a tourism-influenced populated area, Northeastern Iran

5 affiliations
  1. 1Immunology Research Center, Inflammation and Inflammatory Diseases Division, Mashhad University of Medical Sciences, Mashhad, Iran
  2. 2Student Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
  3. 3Department of Mycology and Parasitology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  4. 4Saveh School of Medical Sciences, Saveh, Iran
  5. 5Blood Borne Infections Research Center, Academic Center for Education, Culture and Research (ACECR), Razavi Khorasan, Mashhad, Iran

Abstract

Human papillomavirus (HPV) comprises more than 230 genotypes; its oncogenic potential is a major concern, particularly in tourism-influenced regions. The present study was conducted to assess HPV prevalence and temporal changes in genotype distribution after an eight-year interval in subjects who were suspected of sexually transmitted infections (STIs). Professional physicians referred samples from 2,673 subjects to the main molecular diagnostic labs in North, Razavi, and South Khorasan provinces, as well as from a diverse group of tourists. The findings showed that HPV was detected in 1,185 (55.86%) females and 400 (72.46%) males (p = 0.01). HPV infection was most frequent in the 21–30 and 31–40 year-old groups, at 35.6% and 39.7%, respectively. Most cases clustered around five to six genotypes. The six most frequent genotypes included HPV-6 (56.62%; 77/136), HPV-16 (40.44%; 55/136), HPV-54 (36.03%; 49/136), HPV-43 (29.41%; 40/136), HPV-51 (29.41%; 40/136), and HPV-52 (28.68%; 39/136). Importantly, three prevalent genotypes (16, 51 and 52) are classified as HR-HPV. Compared with eight years ago, the percentage of HPV prevalence strongly increased by more than 28%, primarily in genital discharge samples. The most notable change (0.4% vs 5.1%) occurred in the proportion of individuals with more than four genotypes, i.e., currently 11.7 times higher than eight years ago. The greatest shift in genotype prevalence has occurred between HPV-16 and HPV-51 over the past few years. Moreover, compared to the previous study, minimal changes (0.90%) in prevalence and genotypes have been observed in South Khorasan, the highest in North and Razavi Khorasan provinces (14.5%) and also in tourist groups (3.2%). Therefore, the impact of transient populations and more likely changes in socioeconomic and cultural status in these areas, along with the progressive trends in HPV infection, should prompt health authorities to focus more on establishing HPV diagnostic facilities, screening, vaccination, and increasing public knowledge.

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BibTeX
@article{fadaee2026dynamic,
  title = {{Dynamic changes of HPV genotypes in a tourism-influenced populated area, Northeastern Iran}},
  author = {Afsane Fadaee and Seyed Sajjad Alavi-Kakhki and Samira Basharkhah and Seyed Ali Akbar Shamsian and Zahra Shadman and Narges Valizadeh and Samira Amin Poustchi Tousi and Mohammad Arefi and Fatemeh Sadat Mohammadi and Sanaz Ahmadi Ghezeldasht and Arman Mosavat and Seyed Abdolrahim Rezaee},
  journal = {PLOS One},
  year = {2026},
  month = sep,
  doi = {10.1371/journal.pone.0356563},
  url = {https://doi.org/10.1371/journal.pone.0356563},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Dynamic changes of HPV genotypes in a tourism-influenced populated area, Northeastern Iran
AU  - Afsane Fadaee
AU  - Seyed Sajjad Alavi-Kakhki
AU  - Samira Basharkhah
AU  - Seyed Ali Akbar Shamsian
AU  - Zahra Shadman
AU  - Narges Valizadeh
AU  - Samira Amin Poustchi Tousi
AU  - Mohammad Arefi
AU  - Fatemeh Sadat Mohammadi
AU  - Sanaz Ahmadi Ghezeldasht
AU  - Arman Mosavat
AU  - Seyed Abdolrahim Rezaee
PY  - 2026
DA  - 2026/09/03
JO  - PLOS One
DO  - 10.1371/journal.pone.0356563
UR  - https://doi.org/10.1371/journal.pone.0356563
AB  - Human papillomavirus (HPV) comprises more than 230 genotypes; its oncogenic potential is a major concern, particularly in tourism-influenced regions. The present study was conducted to assess HPV prevalence and temporal changes in genotype distribution after an eight-year interval in subjects who were suspected of sexually transmitted infections (STIs). Professional physicians referred samples from 2,673 subjects to the main molecular diagnostic labs in North, Razavi, and South Khorasan provinces, as well as from a diverse group of tourists. The findings showed that HPV was detected in 1,185 (55.86%) females and 400 (72.46%) males (p = 0.01). HPV infection was most frequent in the 21–30 and 31–40 year-old groups, at 35.6% and 39.7%, respectively. Most cases clustered around five to six genotypes. The six most frequent genotypes included HPV-6 (56.62%; 77/136), HPV-16 (40.44%; 55/136), HPV-54 (36.03%; 49/136), HPV-43 (29.41%; 40/136), HPV-51 (29.41%; 40/136), and HPV-52 (28.68%; 39/136). Importantly, three prevalent genotypes (16, 51 and 52) are classified as HR-HPV. Compared with eight years ago, the percentage of HPV prevalence strongly increased by more than 28%, primarily in genital discharge samples. The most notable change (0.4% vs 5.1%) occurred in the proportion of individuals with more than four genotypes, i.e., currently 11.7 times higher than eight years ago. The greatest shift in genotype prevalence has occurred between HPV-16 and HPV-51 over the past few years. Moreover, compared to the previous study, minimal changes (0.90%) in prevalence and genotypes have been observed in South Khorasan, the highest in North and Razavi Khorasan provinces (14.5%) and also in tourist groups (3.2%). Therefore, the impact of transient populations and more likely changes in socioeconomic and cultural status in these areas, along with the progressive trends in HPV infection, should prompt health authorities to focus more on establishing HPV diagnostic facilities, screening, vaccination, and increasing public knowledge.
SN  - 1932-6203
ER  -