{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T16:45:54Z","timestamp":1787244354094,"version":"build-2736575974"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to determine the genotypic distribution and molecular epidemiology of HPVs in PAP smear samples of women in the UAE using a peptide nucleic acid (PNA)-based fluorescence melting curve analysis method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional retrospective study was conducted between January 2024 to January 2025 after receiving ethical approval from the Institutional Review Board of Gulf Medical University. A total of 229 liquid-based cervical cytology samples were obtained from women aged 20\u201355 years attending the Gynaecology out-patient department of Thumbay University Hospital and other hospitals of the UAE, processed for the routine cytological examination to identify and differentiate morphological changes of the PAP smears. HPV genotyping was performed using PNA-based fluorescence melting curve analysis by the RT-PCR method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 191 HPV genotypes were detected in 96 HPV positive PAP smear samples, including 47 abnormal cytology and 49 NILM samples. 137 HR and 54 LR-HPV genotypes were identified in all 96 positive samples. The highest rate of mixed HR and LR-HPV genotypes (18%) was detected in women aged 31\u201340 years old. HR53, 16, 68, 66, 31, 35, and LR6 were the predominant genotypes. Mixed HR and LR-HPV infection is present in 26% cases; in that HPV53 was the primary genotype, followed by HPV35, 66, 11, 43, 81, 61, and 6.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The genotypes 53, 16, 68, 66, 31, 61, 35, and 6 were the most common genotypes detected in the PAP smear samples. Notably, 21% of normal epithelial cells of the PAP smear samples tested positive for different HR-HPV genotypes. These findings underscore the crucial role of HPV genotyping using RT-PCR, enhancing the effectiveness of screening surveillance and providing foundational data for future prospective studies, vaccination impact assessments, and targeted screening strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0346052","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:39:53Z","timestamp":1774978793000},"page":"e0346052","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Genotypic distribution and molecular epidemiology of HPV in women in the UAE using PNA-based RT PCR"],"prefix":"10.1371","volume":"21","author":[{"given":"Devapriya","family":"Finney","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed Luay Osman","family":"Hashim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil Kumar","family":"Bylappa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameena Ebrahim","family":"Mugar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manivannan","family":"Nandhagopal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6035-559X","authenticated-orcid":true,"given":"Mohammed Abdulrazzaq","family":"Jabbar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8659-3780","authenticated-orcid":true,"given":"Nazeerullah","family":"Rahamathullah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"pone.0346052.ref001","unstructured":"WHO. Human papillomavirus and cancer. (cited on 24 August 2023). https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/human-papilloma-virus-and-cancer"},{"key":"pone.0346052.ref002","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1038\/nrc2886","article-title":"Human papillomavirus oncoproteins: pathways to transformation","volume":"10","author":"CA Moody","year":"2010","journal-title":"Nat Rev Cancer"},{"issue":"7","key":"pone.0346052.ref003","doi-asserted-by":"crossref","first-page":"4262","DOI":"10.1128\/jvi.68.7.4262-4273.1994","article-title":"Inhibition of p53 DNA binding by human papillomavirus E6 proteins","volume":"68","author":"MS Lechner","year":"1994","journal-title":"J Virol"},{"issue":"16","key":"pone.0346052.ref004","doi-asserted-by":"crossref","first-page":"5801","DOI":"10.1128\/MCB.22.16.5801-5812.2002","article-title":"Human papillomavirus oncoprotein E6 inactivates the transcriptional coactivator human ADA3","volume":"22","author":"A Kumar","year":"2002","journal-title":"Mol Cell Biol"},{"key":"pone.0346052.ref005","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1016\/j.virol.2008.11.017","article-title":"Papillomavirus E6 Proteins","volume":"384","author":"HL Howie","year":"2009","journal-title":"Virology"},{"key":"pone.0346052.ref006","doi-asserted-by":"crossref","first-page":"2234","DOI":"10.3390\/v13112234","article-title":"Human papillomaviruses-associated cancers: an update of current knowledge","volume":"13","author":"P Ena","year":"2021","journal-title":"Viruses"},{"key":"pone.0346052.ref007","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jcv.2018.01.006","article-title":"Diagnostic value of human papillomavirus (HPV) 16 and HPV18 viral loads for the detection of high-grade cervical intraepithelial neoplasia (CIN2+) in a cohort of African women living with HIV","author":"M Segondy","year":"2018","journal-title":"J Clin Virol"},{"issue":"11","key":"pone.0346052.ref008","doi-asserted-by":"crossref","first-page":"2691","DOI":"10.3390\/cancers13112691","article-title":"Current Updates on Cancer-Causing Types of Human Papillomaviruses (HPVs) in East, Southeast, and South Asia","volume":"13","author":"C Xia","year":"2021","journal-title":"Cancers (Basel)"},{"issue":"4","key":"pone.0346052.ref009","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1016\/S1470-2045(09)70096-8","article-title":"A review of human carcinogens\u2014Part B: biological agents","volume":"10","author":"V Bouvard","year":"2009","journal-title":"The Lancet Oncology"},{"issue":"9","key":"pone.0346052.ref010","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1016\/j.cmi.2015.05.011","article-title":"Molecular methods for identification and characterization of novel papillomaviruses","volume":"21","author":"BJ Kocjan","year":"2015","journal-title":"Clin Microbiol Infect"},{"issue":"9","key":"pone.0346052.ref011","doi-asserted-by":"crossref","first-page":"719","DOI":"10.2471\/BLT.06.038414","article-title":"Human papillomavirus and HPV vaccines: a review","volume":"85","author":"FT Cutts","year":"2007","journal-title":"Bull World Health Organ"},{"issue":"6","key":"pone.0346052.ref012","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1056\/NEJMoa021641","article-title":"Epidemiologic classification of human papillomavirus types associated with cervical cancer","volume":"348","author":"N Mu\u00f1oz","year":"2003","journal-title":"N Engl J Med"},{"issue":"9","key":"pone.0346052.ref013","article-title":"Exploring the prevalence of Human Papillomavirus (HPV) genotypes in PAP smear samples of women in northern region of United Arab Emirates (UAE): HPV Direct Flow CHIP system-based pilot study","volume":"18","author":"HI Odeh","year":"2023","journal-title":"PLoS One"},{"issue":"9","key":"pone.0346052.ref014","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1002\/ijc.24528","article-title":"Multiple human papillomavirus genotype infections in cervical cancer progression in the study to understand cervical cancer early endpoints and determinants","volume":"125","author":"N Wentzensen","year":"2009","journal-title":"Int J Cancer"},{"issue":"6665","key":"pone.0346052.ref015","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1136\/bmj.298.6665.14","article-title":"The polymerase chain reaction: a new epidemiological tool for investigating cervical human papillomavirus infection","volume":"298","author":"LS Young","year":"1989","journal-title":"BMJ"},{"issue":"5","key":"pone.0346052.ref016","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1002\/cncy.21521","article-title":"The Pap Test and Bethesda 2014","volume":"123","author":"R Nayar","year":"2015","journal-title":"Cancer Cytopathol"},{"key":"pone.0346052.ref017","unstructured":"PANAGENE. PANA RealTyper\u2122 HPV 32 Genotyping Kit. https:\/\/www.hlbpanagene.com\/_ENG\/html\/dh_product\/prod_view\/86\/?cate_no=2"},{"key":"pone.0346052.ref018","unstructured":"Genolution. Nextractor \u00ae NX-48S. Korea. https:\/\/genolution.co.kr\/wp-content\/uploads\/2022\/08\/NX-48N-Br.pdf"},{"key":"pone.0346052.ref019","unstructured":"Genolution. Urine\/Swab DNA Kit US122. https:\/\/genolution.co.kr\/dna-rna-extraction-kit\/"},{"issue":"2","key":"pone.0346052.ref020","doi-asserted-by":"crossref","first-page":"169","DOI":"10.2174\/0250688202666210622110227","article-title":"Type Specific Human Papilloma Virus Prevalence and Distribution in Women with Abnormal Cervical Cytology: A Single Centre Retrospective Observational Study in the Emirate of Abu Dhabi","volume":"2","author":"KG Revannasiddappa","year":"2021","journal-title":"NEMJ"},{"issue":"1","key":"pone.0346052.ref021","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1186\/s13000-018-0716-x","article-title":"Frequency of rare and multi viral high-risk HPV types infection in cervical high grade squamous intraepithelial lesions in a non-native dominant middle eastern country: a polymerase chain reaction-based pilot study","volume":"13","author":"A Albawardi","year":"2018","journal-title":"Diagn Pathol"},{"key":"pone.0346052.ref022","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1016\/j.ijid.2019.12.038","article-title":"Prevalence of human papilloma virus in Oman: Genotypes 82 and 68 are dominating","volume":"93","author":"Z Al-Lawati","year":"2020","journal-title":"Int J Infect Dis"},{"issue":"17","key":"pone.0346052.ref023","first-page":"6367","article-title":"Human Papillomavirus genotypes associated with cervical intraepithelial lesions among Saudi women","volume":"26","author":"FD Alshammari","year":"2022","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"6","key":"pone.0346052.ref024","doi-asserted-by":"crossref","first-page":"350","DOI":"10.5144\/0256-4947.2021.350","article-title":"Prognostic impact of human papillomavirus infection on cervical dysplasia, cancer, and patient survival in Saudi Arabia: A 10-year retrospective analysis","volume":"41","author":"F Alhamlan","year":"2021","journal-title":"Ann Saudi Med"},{"key":"pone.0346052.ref025","unstructured":"HPV Centre. Qatar human papillomavirus and related diseases report. HPV Centre; 2023 (cited on 1 January 2024). Available from: https:\/\/hpvcentre.net\/statistics\/reports\/QAT.pdf?t=1688922352952"},{"issue":"4","key":"pone.0346052.ref026","doi-asserted-by":"crossref","first-page":"137","DOI":"10.4103\/joc.joc_42_22","article-title":"The Prevalence of Cervical HPV Infection and Genotype Distribution in 856,535 Chinese Women with Normal and Abnormal Cervical Lesions: A Systemic Review","volume":"39","author":"Y-Q Yu","year":"2022","journal-title":"J Cytol"},{"issue":"2","key":"pone.0346052.ref027","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1245\/s10434-015-4888-2","article-title":"Inflammatory and Non-inflammatory Breast Cancer: A Potential Role for Detection of Multiple Viral DNAs in Disease Progression","volume":"23","author":"M El-Shinawi","year":"2016","journal-title":"Ann Surg Oncol"},{"issue":"4","key":"pone.0346052.ref028","first-page":"515","article-title":"HPV DNA frequency and subset analysis in human breast cancer patients\u2019 normal and tumoral tissue samples","volume":"25","author":"M Gumus","year":"2006","journal-title":"J Exp Clin Cancer Res"},{"issue":"1","key":"pone.0346052.ref029","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1186\/s12935-021-02009-4","article-title":"High-risk human papillomaviruses and Epstein-Barr virus in breast cancer in Lebanese women and their association with tumor grade: a molecular and tissue microarray study","volume":"21","author":"K Nagi","year":"2021","journal-title":"Cancer Cell Int"},{"issue":"3","key":"pone.0346052.ref030","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1038\/sj.bjc.6604503","article-title":"High-risk human papillomavirus infections in breast cancer in Syrian women and their association with Id-1 expression: a tissue microarray study","volume":"99","author":"N Akil","year":"2008","journal-title":"Br J Cancer"},{"issue":"12","key":"pone.0346052.ref031","first-page":"511","article-title":"Prevalence of Human Papillomavirus Infection and Cervical Abnormalities among Women Attending a Tertiary Care Center in Saudi Arabia over 2 Years","volume":"8","author":"L Faqih","year":"2023","journal-title":"Trop Med Infect Dis"},{"issue":"9","key":"pone.0346052.ref032","doi-asserted-by":"crossref","first-page":"2579","DOI":"10.31557\/APJCP.2019.20.9.2579","article-title":"Colposcopic and Histological Outcome of Atypical Squamous Cells of Undetermined Significance and Atypical Squamous Cell of Undetermined Significance Cannot Exclude High-Grade in Women Screened for Cervical Cancer","volume":"20","author":"O Ortashi","year":"2019","journal-title":"Asian Pac J Cancer Prev"},{"issue":"6","key":"pone.0346052.ref033","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1016\/j.vaccine.2015.12.011","article-title":"Improving the performance of reflex Human Papilloma Virus (HPV) testing in triaging women with atypical squamous cells of undetermined significance (ASCUS): A restrospective study in a tertiary hospital in United Arab Emirates (UAE)","volume":"34","author":"M Fakhreldin","year":"2016","journal-title":"Vaccine"},{"issue":"15","key":"pone.0346052.ref034","doi-asserted-by":"crossref","first-page":"6375","DOI":"10.7314\/APJCP.2015.16.15.6375","article-title":"Age Specific Cytological Abnormalities in Women Screened for Cervical Cancer in the Emirate of Abu Dhabi","volume":"16","author":"M Al Zaabi","year":"2015","journal-title":"Asian Pac J Cancer Prev"},{"key":"pone.0346052.ref035","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.ijid.2021.07.071","article-title":"Prevalence and Genotype Distribution of Human Papillomavirus Infection among 12 076 Iranian Women","volume":"111","author":"F Bitarafan","year":"2021","journal-title":"Int J Infect Dis"},{"key":"pone.0346052.ref036","doi-asserted-by":"crossref","first-page":"489","DOI":"10.2147\/IJWH.S218441","article-title":"Sexual behavior and infection with cervical human papillomavirus types 16 and 18","volume":"11","author":"Y Itarat","year":"2019","journal-title":"Int J Womens Health"},{"issue":"2","key":"pone.0346052.ref037","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1002\/dc.23391","article-title":"Correlation of cervical cytology with high-risk HPV molecular diagnosis, genotypes, and histopathology--A four year study from the UAE","volume":"44","author":"K Krishnan","year":"2016","journal-title":"Diagn Cytopathol"},{"issue":"7","key":"pone.0346052.ref038","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/S1473-3099(07)70158-5","article-title":"Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis","volume":"7","author":"S de Sanjos\u00e9","year":"2007","journal-title":"Lancet Infect Dis"},{"issue":"12","key":"pone.0346052.ref039","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1086\/657321","article-title":"Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings","volume":"202","author":"L Bruni","year":"2010","journal-title":"J Infect Dis"},{"issue":"1","key":"pone.0346052.ref040","doi-asserted-by":"crossref","DOI":"10.1016\/j.lanmic.2024.100955","article-title":"Global prevalence of cervical human papillomavirus in women aged 50 years and older with normal cytology: a systematic review and meta-analysis","volume":"6","author":"V Osmani","year":"2025","journal-title":"Lancet Microbe"},{"key":"pone.0346052.ref041","doi-asserted-by":"crossref","first-page":"1145396","DOI":"10.3389\/fpubh.2023.1145396","article-title":"High-risk HPV prevalence and genotype distribution among women in Liaocheng, Shandong Province, China from 2016 to 2022","volume":"11","author":"L-L Zheng","year":"2023","journal-title":"Front Public Health"},{"issue":"6","key":"pone.0346052.ref042","doi-asserted-by":"crossref","first-page":"403","DOI":"10.5144\/0256-4947.2019.403","article-title":"Prevalence of human papillomavirus in Jeddah, Saudi Arabia","volume":"39","author":"M Mousa","year":"2019","journal-title":"Ann Saudi Med"},{"issue":"1","key":"pone.0346052.ref043","doi-asserted-by":"crossref","first-page":"52","DOI":"10.21103\/Article14(1)_OA7","article-title":"Prevalence and correlation between high-risk HPV genotypes and pap smear findings in Bahrain: a retrospective approach","volume":"14","author":"AM Alnoaimi","year":"2024","journal-title":"Int J Biomed"},{"issue":"10","key":"pone.0346052.ref044","doi-asserted-by":"crossref","first-page":"2496","DOI":"10.3390\/diagnostics12102496","article-title":"Molecular Detection of Human Papillomaviruses in Formalin Fixed Paraffin Embedded Sections from Different Anogenital Lesions in Duhok-Iraq","volume":"12","author":"A Othman","year":"2022","journal-title":"Diagnostics (Basel)"},{"issue":"1","key":"pone.0346052.ref045","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1186\/s12985-024-02435-6","article-title":"High-risk human papillomavirus infection and cervical cytopathology: relationship with cervical nitric oxide levels","volume":"21","author":"DM El-Wakil","year":"2024","journal-title":"Virol J"},{"issue":"2","key":"pone.0346052.ref046","doi-asserted-by":"crossref","DOI":"10.1016\/j.heliyon.2020.e03473","article-title":"Human papillomavirus type 16 and 18 viral loads as predictors associated with abnormal cervical cytology among women in Saudi Arabia","volume":"6","author":"DA Obeid","year":"2020","journal-title":"Heliyon"},{"key":"pone.0346052.ref047","unstructured":"UnitedArab Emirates Ministry of Health and Prevention. Ministry of Health and Prevention adopts proactive HPV prevention strategy, promoting UAE\u2019s leadership in the Eastern Mediterranean. UAE. Accessed 4th April 2025. https:\/\/mohap.gov.ae\/en\/w\/ministry-of-health-and-prevention-adopts-proactive-hpv-prevention-strategy-promoting-uae-s-leadership-in-the-eastern-mediterranean"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0346052","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:40:02Z","timestamp":1774978802000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0346052"}},"subtitle":[],"editor":[{"given":"Ivan","family":"Sabol","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":47,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,31]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0346052","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]}}}