ArticleFrontiers in public health2026
Nationwide epidemiology of HPV E6/E7 mRNA in China: genotype distribution in 11,118 women.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Persistent infection with carcinogenic human papillomavirus (HPV) is the necessary cause of cervical cancer. However, the distribution of transcriptionally active high-risk HPV genotypes across age groups and geographic regions in China remains insufficiently characterized. We aimed to define the nationwide epidemiologic profile of HPV E6/E7 mRNA positivity in China and to evaluate age-, region-, and proxy-defined source-population heterogeneity. Methods: In this retrospective cross-sectional study, 11,118 female cervical specimens retrieved for HPV E6/E7 mRNA testing between August 14, 2024 and October 23, 2025 were analyzed from seven geographic regions of China. Fourteen high-risk HPV genotypes were detected using the Biotron HPV E6/E7 mRNA Genotyping Assay. Descriptive, co-detection, and multivariable logistic regression analyses with institution-level cluster-robust standard errors were performed. Results: Overall high-risk HPV E6/E7 mRNA positivity was 16.32% (1,815/11,118). HPV52, HPV58, and HPV16 were the dominant genotypes, followed by HPV18 and HPV51. Overall positivity varied significantly across age groups, regions, institution-level proxy categories, and department-based clinical-context proxy categories. Central China had the highest overall positivity rate, whereas East China had the lowest. Significant age-related heterogeneity was observed for several major genotypes, especially HPV52, HPV58, and HPV16. Multi-type positivity accounted for 11.8% of positive samples, with HPV52 and HPV58 forming the most prominent co-detection pattern. In multivariable analyses, older age and several non-East regions were associated with higher odds of overall positivity, whereas the opportunistic screening proxy group showed markedly lower odds of positivity than the gynecology-related clinical attendance proxy group. Conclusion: Transcriptionally active high-risk HPV infection in China is characterized by dominance of HPV52, HPV58, and HPV16 and by marked heterogeneity across age, geography, and proxy-defined testing contexts. These findings may support more refined HPV surveillance and risk-adapted prevention strategies.
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