{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T04:28:45Z","timestamp":1788582525915,"version":"build-2803163510"},"reference-count":54,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T00:00:00Z","timestamp":1744156800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Persistent infection with high-risk (HR) HPV genotypes is the main risk factor for the development of cervical cancer. The present analysis provides recent trends on HR-HPV infection rates and the distribution of HR-HPV genotypes among 3500 Greek women between 2021 and 2023. Methods: The detection of HR-HPVs and the specific identification of HPV16 and HPV18 were conducted using the Roche Cobas 4800 HPV assay. The genotyping of 12 other HR-HPV genotypes was performed through the Nested Multiplex PCR methodology (NMPCR). Results: The overall infection rate was 8.8% with the most prevalent HR-HPV genotype being HPV16 followed by HPV31, HPV66, HPV56, HPV51, HPV58, HPV45, HPV18, HPV68, HPV59, HPV52, HPV35, HPV39, and HPV33. Among HR-HPV-positive cases the prevalence of single, double, triple, and quadruple infections was 73.9%, 19.9%, 5.5%, and 0.7%, respectively. Age-specific analysis showed that the HR-HPV infection rate was higher in the age group of 31\u201335 years (25.5%) and it was estimated that multiple infections occur more often in younger women. Notably, the distribution of HR-HPV genotypes varies among different age groups. It is proposed that HPV16, HPV31, HPV56, and HPV66 may show an increased possibility of establishing long-term infections in Greek women over 36 years old. Conclusions: The high rates of specific HR-HPVs which are not included in the prophylactic vaccines underlines the significance of constant surveillance of circulating HPVs in the Greek population.<\/jats:p>","DOI":"10.3390\/cancers17081267","type":"journal-article","created":{"date-parts":[[2025,4,9]],"date-time":"2025-04-09T05:03:07Z","timestamp":1744174987000},"page":"1267","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Prevalence and Genotype Distribution of High-Risk HPV Genotypes Among Women in Greece: A Retrospective Analysis of 3500 Women"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6835-8410","authenticated-orcid":false,"given":"Dimitris","family":"Tsakogiannis","sequence":"first","affiliation":[{"name":"Research Center, Hellenic Anticancer Institute, 10680 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9540-7553","authenticated-orcid":false,"given":"Eleni","family":"Zografos","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, General Hospital Alexandra, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-5693-4855","authenticated-orcid":false,"given":"Lamprini","family":"Tzioga","sequence":"additional","affiliation":[{"name":"Research Center, Hellenic Anticancer Institute, 10680 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8203-6407","authenticated-orcid":false,"given":"Constantinos G.","family":"Zografos","sequence":"additional","affiliation":[{"name":"A\u2019 Surgery Department, Laiko General University Hospital of Athens, 11527 Athina, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7153-6556","authenticated-orcid":false,"given":"Flora","family":"Zagouri","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics, General Hospital Alexandra, 11528 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garyfalia","family":"Bletsa","sequence":"additional","affiliation":[{"name":"Research Center, Hellenic Anticancer Institute, 10680 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,9]]},"reference":[{"key":"ref_1","first-page":"F55","article-title":"Papillomavirus infections\u2014A major cause of human cancers","volume":"1288","year":"1996","journal-title":"Biochim. Biophys. Acta"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1099\/jgv.0.001072","article-title":"ICTV Virus Taxonomy Profile: Papillomaviridae","volume":"99","author":"Chen","year":"2018","journal-title":"J. Gen. Virol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1007\/s00705-013-1790-8","article-title":"Nucleotide polymorphisms of the human papillomavirus 16 E1 gene","volume":"159","author":"Tsakogiannis","year":"2014","journal-title":"Arch. Virol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1729","DOI":"10.1007\/s00705-012-1356-1","article-title":"Molecular and phylogenetic analysis of the HPV 16 E4 gene in cervical lesions from women in Greece","volume":"157","author":"Tsakogiannis","year":"2012","journal-title":"Arch. Virol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.virol.2010.02.002","article-title":"Classification of papillomaviruses (PVs) based on 189 PV types and proposal of taxonomic amendments","volume":"401","author":"Bernard","year":"2010","journal-title":"Virology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1071","DOI":"10.1002\/ijc.21655","article-title":"Genome variation of human papillomavirus types: Phylogenetic and medical implications","volume":"118","author":"Bernard","year":"2006","journal-title":"Int. J. Cancer"},{"key":"ref_7","unstructured":"Humans IWGotEoCRt (2007). Humans IWGotEoCRt. Human papillomaviruses. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans, IARC."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/978-981-10-5765-6_3","article-title":"Human Papillomavirus-Related Cancers","volume":"1018","author":"Li","year":"2017","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1038\/nature16481","article-title":"Structure of the E6\/E6AP\/p53 complex required for HPV-mediated degradation of p53","volume":"529","author":"Ruiz","year":"2016","journal-title":"Nature"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Shimada, M., Yamashita, A., Saito, M., Ichino, M., Kinjo, T., Mizuki, N., Klinman, D.M., and Okuda, K. (2020). The human papillomavirus E6 protein targets apoptosis-inducing factor (AIF) for degradation. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-71134-3"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1016\/j.gene.2018.03.026","article-title":"E7 oncoprotein of human papillomavirus: Structural dynamics and inhibitor screening study","volume":"658","author":"Aarthy","year":"2018","journal-title":"Gene"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1038\/s41392-024-02083-w","article-title":"Roles of human papillomavirus in cancers: Oncogenic mechanisms and clinical use","volume":"10","author":"Zhang","year":"2025","journal-title":"Signal Transduct. Target. Ther."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e19","DOI":"10.1017\/erm.2021.18","article-title":"Genetic variability of the HPV16 early genes and LCR. Present and future perspectives","volume":"23","author":"Bletsa","year":"2021","journal-title":"Expert Rev. Mol. Med."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Zygouras, I., Leventakou, D., Pouliakis, A., Panagiotou, S., Tsakogiannis, D., Konstantopoulos, G., Logotheti, E., Samaras, M., Kyriakopoulou, Z., and Beloukas, A. (2023). Human Papillomavirus 16 DNA Methylation Patterns and Investigation of Integration Status in Head and Neck Cancer Cases. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms241914593"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA A Cancer J. Clin."},{"key":"ref_16","unstructured":"Bruni, L.A.G., Serrano, B., Mena, M., Collado, J.J., G\u00f3mez, D., Mu\u00f1oz, J., Bosch, F.X., and de Sanjos\u00e9, S. (2025, February 26). ICO\/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in Greece. Summary Report 10 March 2023. Available online: https:\/\/hpvcentre.net\/statistics\/reports\/GRC.pdf."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Tsakogiannis, D., Nikolaidis, M., Zagouri, F., Zografos, E., Kottaridi, C., Kyriakopoulou, Z., Tzioga, L., Markoulatos, P., Amoutzias, G.D., and Bletsa, G. (2022). Mutation Profile of HPV16 L1 and L2 Genes in Different Geographic Areas. Viruses, 15.","DOI":"10.3390\/v15010141"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1016\/S0140-6736(13)62218-7","article-title":"Efficacy of HPV-based screening for prevention of invasive cervical cancer: Follow-up of four European randomised controlled trials","volume":"383","author":"Ronco","year":"2014","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e96","DOI":"10.1016\/S2468-2667(17)30007-5","article-title":"Primary HPV testing versus cytology-based cervical screening in women in Australia vaccinated for HPV and unvaccinated: Effectiveness and economic assessment for the National Cervical Screening Program","volume":"2","author":"Lew","year":"2017","journal-title":"Lancet Public Health"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1002\/ijc.35200","article-title":"Clinically validated HPV assays offer comparable long-term safety in primary cervical cancer screening: A 9-year follow-up of a population-based screening cohort","volume":"156","author":"Kroon","year":"2025","journal-title":"Int. J. Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1017\/erm.2017.2","article-title":"Molecular approaches for HPV genotyping and HPV-DNA physical status","volume":"19","author":"Tsakogiannis","year":"2017","journal-title":"Expert Rev. Mol. Med."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"321","DOI":"10.3322\/caac.21628","article-title":"Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society","volume":"70","author":"Fontham","year":"2020","journal-title":"CA Cancer J. Clin."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/LGT.0000000000000525","article-title":"2019 ASCCP Risk-Based Management Consensus Guidelines for Abnormal Cervical Cancer Screening Tests and Cancer Precursors","volume":"24","author":"Perkins","year":"2020","journal-title":"J. Low. Genit. Tract Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"4030","DOI":"10.1002\/cncr.33795","article-title":"Worldwide trends in cervical cancer incidence and mortality, with predictions for the next 15 years","volume":"127","author":"Lin","year":"2021","journal-title":"Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1007\/s00404-020-05879-7","article-title":"Human papilloma virus (HPV) prevalence upon HPV vaccination in Swedish youth: A review based on our findings 2008-2018, and perspectives on cancer prevention","volume":"303","author":"Du","year":"2021","journal-title":"Arch. Gynecol. Obstet."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Oyervides-Munoz, M.A., Perez-Maya, A.A., Sanchez-Dominguez, C.N., Berlanga-Garza, A., Antonio-Macedo, M., Valdez-Chapa, L.D., Cerda-Flores, R.M., Trevino, V., Barrera-Saldana, H.A., and Garza-Rodriguez, M.L. (2020). Multiple HPV Infections and Viral Load Association in Persistent Cervical Lesions in Mexican Women. Viruses, 12.","DOI":"10.3390\/v12040380"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12985-023-01959-7","article-title":"Prevalence and genotype distribution of human papillomavirus infections in Beijing, China between 2016 and 2020","volume":"20","author":"Zhang","year":"2023","journal-title":"Virol. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"3176","DOI":"10.1128\/JCM.42.7.3176-3184.2004","article-title":"Detection and typing of human papillomavirus by e6 nested multiplex PCR","volume":"42","author":"Sotlar","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"522","DOI":"10.1038\/s41571-024-00904-z","article-title":"Epidemiology of HPV-associated cancers past, present and future: Towards prevention and elimination","volume":"21","author":"Malagon","year":"2024","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e197","DOI":"10.1016\/S2214-109X(22)00501-0","article-title":"Global estimates of incidence and mortality of cervical cancer in 2020: A baseline analysis of the WHO Global Cervical Cancer Elimination Initiative","volume":"11","author":"Singh","year":"2023","journal-title":"Lancet Glob Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"3679","DOI":"10.1038\/s41467-024-47909-x","article-title":"Concomitant human papillomavirus (HPV) vaccination and screening for elimination of HPV and cervical cancer","volume":"15","author":"Gini","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Kutz, J.M., Rausche, P., Gheit, T., Puradiredja, D.I., and Fusco, D. (2023). Barriers and facilitators of HPV vaccination in sub-saharan Africa: A systematic review. BMC Public Health, 23.","DOI":"10.1186\/s12889-023-15842-1"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Wendland, E.M., Villa, L.L., Unger, E.R., Domingues, C.M., and Benzaken, A.S. (2020). Prevalence of HPV infection among sexually active adolescents and young adults in Brazil: The POP-Brazil Study. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-61582-2"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"10732748221103331","DOI":"10.1177\/10732748221103331","article-title":"Prevalence and Distribution of Human Papillomavirus Genotypes (1997\u20132019) and Their Association with Cervical Cancer and Precursor Lesions in Women from Southern Mexico","volume":"29","year":"2022","journal-title":"Cancer Control"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1897","DOI":"10.1080\/21645515.2019.1578592","article-title":"Nativity status and genital HPV infection among adults in the U.S","volume":"15","author":"Bhattacharya","year":"2019","journal-title":"Hum. Vaccin. Immunother."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1186\/s12985-024-02447-2","article-title":"Prevalence and genotype distribution of human papillomavirus infection among 66000 women from 2014 to 2023 in the plateau region of Southwest China","volume":"21","author":"Hu","year":"2024","journal-title":"Virol. J."},{"key":"ref_37","unstructured":"Bruni, L., Albero, G., Serrano, B., Mena, M., Collado, J.J., G\u00f3mez, D., Mu\u00f1oz, J., Bosch, F.X., and de Sanjos\u00e9, S. (2025, February 26). ICO\/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Diseases in the World. Summary Report 10 March 2023. Available online: https:\/\/hpvcentre.net\/statistics\/reports\/XWX.pdf."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1097\/CEJ.0000000000000060","article-title":"Epidemiology of HPV infection and current status of cervical cancer prevention in Greece: Final results of the LYSISTRATA cross-sectional study","volume":"23","author":"Agorastos","year":"2014","journal-title":"Eur. J. Cancer Prev."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1097\/CEJ.0b013e32832abd5e","article-title":"Prevalence and distribution of high-risk human papillomavirus in Greece","volume":"18","author":"Agorastos","year":"2009","journal-title":"Eur. J. Cancer Prev."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Argyri, E., Papaspyridakos, S., Tsimplaki, E., Michala, L., Myriokefalitaki, E., Papassideri, I., Daskalopoulou, D., Tsiaoussi, I., Magiakos, G., and Panotopoulou, E. (2013). A cross sectional study of HPV type prevalence according to age and cytology. BMC Infect. Dis., 13.","DOI":"10.1186\/1471-2334-13-53"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1111\/j.1469-0691.2011.03505.x","article-title":"Molecular epidemiology of HPV infection using a clinical array methodology in 2952 women in Greece","volume":"17","author":"Tsiodras","year":"2011","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1898","DOI":"10.1002\/jmv.21025","article-title":"Prevalence of human papillomavirus types 6, 11, 16, 18, 31, and 33 in a cohort of Greek women","volume":"79","author":"Panotopoulou","year":"2007","journal-title":"J. Med. Virol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1159\/000442512","article-title":"Multiple Human Papilloma Virus Infections and Their Impact on the Development of High-Risk Cervical Lesions","volume":"59","author":"Salazar","year":"2015","journal-title":"Acta Cytol."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Bruno, M.T., Scalia, G., Cassaro, N., and Boemi, S. (2020). Multiple HPV 16 infection with two strains: A possible marker of neoplastic progression. BMC Cancer, 20.","DOI":"10.1186\/s12885-020-06946-7"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"e16247","DOI":"10.7717\/peerj.16247","article-title":"Characteristic of persistent human papillomavirus infection in women worldwide: A meta-analysis","volume":"11","author":"Zhao","year":"2023","journal-title":"PeerJ"},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Na, J., Li, Y., Wang, J., Wang, X., Lu, J., and Han, S. (2023). The correlation between multiple HPV infections and the occurrence, development, and prognosis of cervical cancer. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1220522"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1186\/s12985-023-02262-1","article-title":"Prevalence and genotype distribution of human papillomavirus infection among women in Jingzhou, China: A population-based study of 51,720 women","volume":"20","author":"Liu","year":"2023","journal-title":"Virol. J."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"42","DOI":"10.21873\/cdp.10283","article-title":"Prevalence of Multiple High Risk Human Papilloma Virus (HR-HPV) Infections in Cervical Cancer Screening in Lazio Region, Italy","volume":"4","author":"Pisani","year":"2024","journal-title":"Cancer Diagn. Progn."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e35736","DOI":"10.1016\/j.heliyon.2024.e35736","article-title":"Patterns of single and multiple HPV infections in female: A systematic review and meta-analysis","volume":"10","author":"Zhou","year":"2024","journal-title":"Heliyon"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1093\/eurpub\/ckae075","article-title":"Understanding the high-risk human papillomavirus prevalence and associated factors in the European country with a high incidence of cervical cancer","volume":"34","author":"Berza","year":"2024","journal-title":"Eur. J. Public Health"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"8641","DOI":"10.1002\/cam4.4340","article-title":"Age-specific prevalence of human papillomavirus and abnormal cytology at baseline in a diverse statewide prospective cohort of individuals undergoing cervical cancer screening in Mississippi","volume":"10","author":"Clarke","year":"2021","journal-title":"Cancer Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e29190","DOI":"10.1002\/jmv.29190","article-title":"Prevalence and genotype distribution of human papillomavirus in cervical adenocarcinoma (usual type and variants): A systematic review and meta-analysis","volume":"95","author":"Reynders","year":"2023","journal-title":"J. Med. Virol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"4366","DOI":"10.1002\/cam4.4732","article-title":"Age-specific prevalence and genotype distribution of human papillomavirus in women from Northwest China","volume":"11","author":"Lin","year":"2022","journal-title":"Cancer Med."},{"key":"ref_54","first-page":"17455065211020702","article-title":"Human papillomavirus persistence or clearance after infection in reproductive age. What is the status? Review of the literature and new data of a vaginal gel containing silicate dioxide, citric acid, and selenite","volume":"17","author":"Huber","year":"2021","journal-title":"Women\u2019s Health"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/8\/1267\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:13:04Z","timestamp":1760029984000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/8\/1267"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,9]]},"references-count":54,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["cancers17081267"],"URL":"https:\/\/doi.org\/10.3390\/cancers17081267","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,9]]}}}