Epidemiology of high-risk HPV in Uzbekistan among 44,000 women - genotypes, risk profiles and screening needs in Uzbekistan.

BACKGROUND: Cervical cancer imposes a substantial public health burden in Uzbekistan, yet comprehensive HPV epidemiological data are lacking. This study characterized high-risk HPV prevalence, genotype distribution, risk factors, and screening coverage in three key regions. METHODS: We analyzed data from 44,497 women aged ≥ 20 years attending gynecological services in Tashkent, Andijan, and Samarkand (2021–2023). Liquid-based cytology and HPV DNA testing for 12 high-risk genotypes were performed. Sociodemographic, reproductive, behavioral, and clinical variables were collected via standardized questionnaires and examination. Multivariable logistic regression identified associated factors of high-risk HPV infection. RESULTS: High-risk HPV was detected in 3,779 women (8.5%), with regional prevalence of 9.2% in Andijan, 8.8% in Tashkent, and 6.5% in Samarkand. Mixed genotype infections comprised 52.8% of cases; HPV-16/18 accounted for 41.1%. Among HPV-positive women undergoing cytology (n = 2,275), 64.1% had negative findings, 14.7% LSIL, 8.4% ASC-US, 6.9% HSIL, 5.1% ASC-H, 0.5% atypical glandular cells, and 0.3% carcinoma. Independent predictors of HPV infection included younger age, single marital status, lower parity, abortion history, and hormonal contraception (all p < 0.05). Foamy vaginal discharge was a significant clinical predictor (adjusted OR 1.53; p < 0.01). CONCLUSIONS: Uzbekistan exhibits an intermediate high-risk HPV burden, dominated by vaccine-preventable genotypes, and low screening coverage. Targeted outreach to identified high-risk groups—by age, reproductive history, and clinical features—will optimize resource allocation. These data support accelerated progress toward WHO elimination targets in Uzbekistan.