Abstract
OBJECTIVE: This population-based study investigated longitudinal changes in the prevalence and genotype distribution of HPV across the pre-pandemic (2017-2019), pandemic (2020-2022), and post-pandemic (2023-2024) periods in Western China. METHODS: We conducted a retrospective cohort analysis of 129,585 women, stratified into three chronological cohorts: pre-pandemic (n=40,044), pandemic (n=43,717), and post-pandemic (n=45,824) cohorts. Cervicovaginal specimens were analyzed via real-time PCR-based genotyping to detect 16 high-risk and 7 low-risk genotypes. Age-specific prevalence patterns were evaluated across six demographic strata (<20 to ≥60 years). Age-standardized prevalence rates were calculated using 2020 Chinese census data as a reference population. RESULTS: The total HPV prevalence decreased from 31.59% before the pandemic to 23.28% during the pandemic, stabilizing at 21.45% after the pandemic. Nonvaccine-targeted HR-HPV subtypes (HPV-52, HPV-58) maintained persistent dominance across all phases, with the prevalence of HPV-52 decreasing from 6.00% before the pandemic to 3.00% after the pandemic. Adolescents (<20 years) presented the lowest infection rates, whereas peak rates were reported for women aged 40-49 years. CONCLUSIONS: The sustained reduction in total HPV prevalence is potentially associated with pandemic-related behavioral modifications and healthcare disruptions. The persistent circulation of nonvaccine-targeted subtypes highlights gaps in current prevention strategies. These findings emphasize the need for comprehensive surveillance integrating catch-up screening and genotype-specific vaccine development to address post-pandemic HPV transmission dynamics.