Multiple High-Risk HPV Infections and Opportunistic HPV Prevalence Among Women Aged 18-25 Years with NILM, ASC-US, or LSIL Cytology: A 2024 Cross-Sectional Study.

Multiple high-risk human papillomavirus (hrHPV) infections in young women are poorly characterized across age and cytology, particularly with partial genotyping. We assessed multiple hrHPV infections among HPV-positive women aged 18-25 years with NILM, ASC-US, or LSIL; the secondary objective was hrHPV positivity among electively tested women with NILM. This retrospective cross-sectional study analyzed 2024 laboratory data from northern Slovakia. Of 7613 unique women, 7574 met cytological eligibility criteria; 804 underwent cobas 4800 testing, and 295 were hrHPV-positive. Multiple infection, defined as concurrent detection of at least two reportable categories (HPV16, HPV18, or other hrHPV), occurred in 69/295 women (23.4%; 95% CI, 18.9-28.5%). No statistically detectable variation was observed by cytology after age adjustment (p = 0.471) or by age after cytology adjustment (p = 0.891). Among women with multiple infections, HPV16 combined with other hrHPV was the most frequent pattern (30/69; 43.5%). Among 396 electively tested women with NILM, 75 were hrHPV-positive (18.9%; 95% CI, 15.4-23.1%); positivity was lower at ages 23-25 than 18-22 (10.6% vs. 26.6%; OR, 0.33; 95% CI, 0.19-0.57; p < 0.001). The NILM estimate describes a self-selected preventive cohort and is not population-representative.