Molecular profiling of human papillomavirus genotypes, cytomorphological abnormalities, and their predictors in Cameroon: a multi-regional analysis

Cervical cancer-related mortality remains high in Cameroon, yet data on high-risk human papillomavirus (HR-HPV) genotypes are sparse. This study characterized HR-HPV profiles and evaluated associations with cytomorphological abnormalities and clinical predictors. We enrolled 555 women (≥25 years) from four regions in Cameroon. Cervical samples underwent cytological evaluation and HR-HPV genotyping using polymerase chain reaction (PCR)-based assays (Abbott Laboratories, USA; Sacace Biotechnologies, Italy). Questionnaires were used to collect sociodemographic/clinical data, and associations with cytological abnormalities and clinical factors were assessed using multivariable logistic regression. HR-HPV prevalence was 26.5%, dominated by HPV16 (21.1%), HPV68 (19.4%), and HPV45 (14.3%). Multiple infections (38.8%) significantly increased risks for high-grade squamous intraepithelial lesions (HSIL; odds ratio [OR]=1.59, p=0.002) and squamous cell carcinoma (SCC; OR=2.81, p<0.001). HPV16 showed the strongest association with SCC (OR=23.74, p<0.001) while HPV45 (OR=2.91, p=0.039), HPV31 (OR=4.15, p=0.018), HPV33 (OR=5.47, p=0.039) and HPV52 (OR=6.60, p=0.023) showed significant associations with HSIL and SCC. Significant clinical predictors (p<0.001) included age, parity, tobacco, and HIV-positive status. Our study confirms the diverse HR-HPV genotype profile in Cameroon, with notable frequencies of non-16/18 genotypes and multiple infections. These findings underscore the need for broader-spectrum vaccines and risk-based screening in Cameroon.