Persistent infections with high-risk human papillomavirus (HR-HPV) are linked to cervical cancer progression. The prevalence and distribution of HPV genotypes vary across regions and lesion severity. Comprehensive data on HPV genotype distribution among Iranian women is limited. This study investigates the distribution of HR-HPV genotypes in women with abnormal cytology in Qazvin province, northwest Iran, from 2007 to 2019.

A total of 103 samples, including benign cases, Low-grade Squamous Intraepithelial Lesions (LSIL), High-grade Squamous Intraepithelial Lesions (HSIL), and Invasive Cervical Cancer (ICC), were analyzed using real-time PCR to detect HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 58, and 59.

The study revealed a high HPV prevalence (92.23%), with HPV-16 being the most common genotype (66.31%), followed by HPV-45 (49.47%), HPV-33 (41.05%), HPV-31(30.52%) and HPV-52 (23.15%). HPV-18 was detected only in 3 (3.15%) of cases. Of the HPV-positive samples, 82.11% had multiple infections, with HPV-16, HPV-33, and HPV-45 more prevalent in these cases. HPV-16 was significantly associated with severe lesions, particularly in ICC cases (92%, P = 0.007).

These findings emphasize the role of HPV genotyping in assessing cervical lesion severity and oncogenic risk, highlighting HPV-16 as the dominant genotype across various lesion grades. The study suggests that HPV-33 and HPV-45 may also contribute significantly to cervical lesion progression.