Avaliação epidemiológica do perfil genotípico do papiloma vírus humano e da taxa de circulação com outras ISTs em um cenário urbano no nordeste brasileiro

Abstract

Human papillomavirus (HPV) is the main etiological agent of cervical cancer and presents a wide diversity of genotypes, whose circulation is influenced by behavioral and biological factors and by the local epidemiological context, including the presence of other sexually transmitted infections (STIs). This study describes the prevalence, HPV genotypic profile, and occurrence of co-infections with bacterial STIs in 1,391 women attending primary care in the municipality of Eusébio, Ceará. The samples were analyzed by molecular methods of extended genotyping for HPV and seven other STIs, enabling the identification of single and multiple infections. The overall positivity for HPV was 12.1%, with a significantly lower median age among HPV-positive women compared to HPV-negative women. The age distribution was consistent with the classic epidemiological behavior of HPV, with a concentration of cases in young women and a slight increase in the over-65 age group, suggesting possible viral reactivation in older ages. The most frequent genotypes were HPV52, HPV56, HPV58, HPV68, HPV42, and HPV53, indicating a predominance of types not covered by the quadrivalent vaccine available through the country's public health system. Analysis of vaccinated women revealed a low frequency of genotypes covered by the vaccine, reinforcing that vaccination is preventive and has a greater impact when administered before exposure to the virus. Approximately 46% of women tested positive for one of the STIs tested, particularly Ureaplasma parvum, Mycoplasma hominis, and Ureaplasma urealticum. The statistically significant association between high-risk HPV and M. hominis, as well as between high-risk HPV and U. urealyticum, indicates that bacterial co-infections may influence viral persistence and modify the genital microenvironment. The findings demonstrate that the local epidemiological scenario requires integrated actions involving timely vaccination, continuous screening, and adequate management of STIs in order to reduce the circulation of oncogenic genotypes and strengthen the prevention of cervical cancer.